Join or Renew Local First | Vital Communities

First Name

Last Name

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Address

Address 2

Postal Code

City

State / Province

Company/Organization Name

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CARD PAYPAL BANK TRANSFER

Card Number

MM / YY

CVC Code

The 3-4 digits on the back of your credit card

Billing ZIP Code

Enter the Zip/Postal code for your credit card billing address

By clicking Donate, you authorise VITAL COMMUNITIES to debit the bank account that you connect to for any amount owed for charges arising from your use of VITAL COMMUNITIES’ services and/or purchase of products from VITAL COMMUNITIES, pursuant to VITAL COMMUNITIES’ website and terms, until this authorisation is revoked. You may amend or cancel this authorisation at any time by providing notice to VITAL COMMUNITIES with 30 (thirty) days notice.

If you use VITAL COMMUNITIES’ services or purchase additional products periodically pursuant to VITAL COMMUNITIES’ terms, you authorise VITAL COMMUNITIES to debit your bank account periodically. Payments that fall outside the regular debits authorised above will only be debited after your authorisation is obtained.

Bank Name

Account Type

Account Last 4

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