Brotherhood Legacy Program

  • Automatic Donation Agreement Form
    This is your authorization to charge my account on the 1st day of every month, beginning with
  • which will be deposited with Phi Kappa Tau Housing Corporation Beta Kappa Chapter.
  • 9 digit number
  • Min 6 digits - Max 17 digits
  • This authority is to remain in full force and effect until Phi Kappa Tau Housing Corporation Beta Kappa Chapter has received written notification from me of its termination in such time and in such manner as to afford a reasonable opportunity to act on it or when Phi Kappa Tau Housing Corporation Beta Kappa Chapter determines it necessary to discontinue the automatic payment program. I (we) acknowledge that the origination of ACH transactions to my (our) account must comply with the provisions of US law.
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    Placing cursor inside box will turn it into a pen so that you may apply a signature to this form.