Online Swim-a-thon Participant Donation Request

Swim-a-thon Fundraiser
Thank you for supporting Berkshire South's Swim-a-thon Fundraiser. This secure form allows you to make a gift using your VISA, Mastercard or Discover credit card. You may also choose to send a check by mail to:

Berkshire South Regional Community Center
c/o Development Department
15 Crissey Road
Great Barrington, MA 01230

Section I — Personal Information:

 
 
 
 
 
 

Section II — About Your Gift:

Swimmer's Name: 
Dedication:     

Section III — Contribution:

(OPTION 1) a one time gift made through a MasterCard, Visa, or Discover credit card.
(OPTION 2) a recurring gift made on a monthly basis through an automatic withdrawal from a credit card, savings account, or checking account. An EFT Contribution can be made on a term basis (with a start and end date), or on an Open-Ended basis (Ongoing with 15 days notice before termination of transfers).

OPTION 1. Direct Contribution payment information

$
     
    

OPTION 2. Electronic Transfer payment information

This agreement authorizes the Center to bill your credit card or bank account (as specified below) each month through the term of the agreement for your dues. Donors who choose to elect for an Open-Ended EFT contribution, may advise the Community Center in writing at least fifteen (15) days prior to the time they choose to terminate their EFT contributions. Please note: All monthly payment plans that are returned with insufficient funds are subject to a $20 fee.

I would like to have an Open-Ended EFT Contribution:   
EFT Contribution:
    
 $   
 
     
 
    
 
 
    
 

This request is being made voluntarily and at any time I may cancel by sending a letter to:
Berkshire South Regional Community Center
Attn: Development Department
15 Crissey Road
Great Barrington, MA 01230