PLEASE RETURN COMPLETED FORM, ALONG WITH A VOIDED CHECK (CHECKING ACCOUNT) TO:

Olivia Burk, Business Manager

St. Wenceslaus Catholic Church
505 Third Street East
Dickinson, ND 58601

A copy of this form will be returned to you along with a letter of acknowledgement.

Automatic Withdrawal Form

High Plains Dental P.C. Sponsorship Banner Floor To Ceiling Carpet One Floor & Home Sponsorship Banner Benedictine Living Community-Dickinson Sponsorship Banner
Gaffaney's Floral Sponsorship Banner Knights of Columbus Sponsorship Banner

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