Waldron Mercy Academy -> Support WMA -> Charge My Student Billing Account

I authorize Waldron Mercy Academy to charge my student billing account for the Annual Giving Campaign.

Student Name: (required)

Parent/Guardian Name: (required)

Please choose one of the following options:

ONE TIME GIFT

I would like my account to be charged an additional amount of:

Please charge this amount in the month of:

PLEDGE

I would like my account to be charged on a monthly basis in the amount of:

Please charge this amount in the following months:

	January '10		February '10		March '10		April '10
	May '10		June '10

Total amount of my pledge:

E-mail Address (required)

Please send an e-mail confirmation to the following e-mail address:

You are about to submit your form online. Please be sure that all of the required information above is completed. Otherwise, your form will not submit to the development office, the form will reset and the required information will appear in red until it has been completed. Once you hit submit, you should receive an e-mail notification immediately. If you do not receive the e-mail notification, please contact Susan O’Neill at soneill@waldronmercy.org. Once you have checked your information, then click "submit" below. Thank you for your cooperation.