Thank you for your interest in the National Federation of the Blind's Pre-Authorized Contribution (PAC) program. This program allows you to contribute to the NFB through recurring monthly donations. These can be direct withdrawals from a checking account or charges to a credit card. Please contact email@example.com with any questions. Thank you for your generosity.
Since you've indicated that this form is on behalf of an organization, please complete the remaining fields using the organization’s information. Please provide a phone number where we can reach an organization representative to confirm and complete this process.
In order to receive your submission receipt and possible future correspondence, we need a valid email address.
If you are a new donor, we will call you for your bank or credit card information.
I authorize National Federation of the Blind (NFB) to debit the bank account or charge the credit card for the dollar amount I have indicated on this form on the date I will provide to an NFB staff member. I understand this authorization will remain in effect until I cancel it in writing. I agree to notify NFB in writing of any changes in my account information or termination of this authorization at least five (5) business days prior to the next monthly transaction date. If the payment date falls on a weekend or holiday, I understand that the payment may be executed on the next business day. I understand that because this is an electronic transaction, these funds will be withdrawn from my account on the transaction date I choose. I acknowledge that the origination of ACH or credit card transactions to my account must comply with provisions in U.S. law. I will not dispute National Federation of the Blind’s recurring billing of my bank so long as the transaction corresponds to the terms indicated in this agreement.