Recurring Monthly Donation | Story-formed Life (Story Formed Inc.)

First Name

Last Name

Phone

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Address

Address 2

Postal Code

City

State / Province

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

If you use STORY FORMED INC.’ services or purchase additional products periodically pursuant to STORY FORMED INC.’ terms, you authorise STORY FORMED INC. 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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