Wreaths Across America Recurring Donation Authorization Form

Full Name*

First Name

Last Name

Billing Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Email*

For Your Reciepts

Phone*

Sponsorship Frequency *

Please Select Your Requested Billing Frequency

Day Of Month To Charge *

Please Select A Date For Your Rebillings. Please Note, If The Date You Selected Has Gone By, It Will Start Processing On The Next Month

Location ID (Not Required)

Please Enter Your Location ID If Applicable

Sponsorship Group ID (Not Required)

Please Enter Your Sponsorship Group ID If Applicable

In Memory / In Honor / Grave Specifics

Please Enter In Memory, In Honor, and Grave Specific Information Here. If The Requested Location Does Not Accept Grave Specific Requests, A Member Of The Team Will Reach Out.

Requested Charge Amount: * $

Please Enter The Amount You Wish To Sponsor. Wreath sponsorships are $17.00 per wreath.

Credit Card Number*

CVV Code*

Expiration Date *

Please sign below to accept the Credit Card Authorization Agreement:

I authorize a recurring charge to my credit card per the terms that I have entered above. I understand that I will be charged the amount indicated above each specified billing period that I selected. A receipt for each payment will be provided to me as soon as the transaction is processed and the charge will appear on my statement. Wreaths Across America will send me a reminder email a few days before my charge, and I acknowledge that I will then have 48 hours from that notice to request a pause or cancelation on my recurring charge. I understand that I can call 877-385-9504 at any time to make changes or to cancel this at no additional cost to me. Please note that anything requested after the cutoff date of 11/29/2024 is not guaranteed for placement this year. If you need your charge to apply for 2024, please select a different date or contact a member of Customer Service at 877-385-9504 or by emailing helpdesk@wreathsacrossamerica.org

Signature*

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Use your mouse or finger to draw your signature above

Sponsor Information