Payment Details I would like to: – Pay a deposit of $....................... to confirm my place in this retreat Pay the full amount of $....................... for this retreat Method of payment: Direct Debit (PREFFERRED): BSB: 063 - 142 Account No: 1030 - 7889 Account Name: Society of Jesus Campion CIS My cheque is enclosed, crossed NEGOTIABLE” and made payable to “NOT Centre of Ignatian Spirituality” “Campion debit my, Mastercard Visacard Name appearing on credit card: ________________________________________________ / Expiry Date: Signature:___________________________________ *Please note that credit card surcharge may incur.
Payment Details – I would like to: Pay a deposit of $....................... to confirm my place in this retreat Pay the full amount of $....................... for this retreat Method of payment: Direct Debit (PREFFERRED): BSB: 063 - 142 Account No: 1030 - 7889 Account Name: Society of Jesus Campion CIS My cheque is enclosed, crossed “NOT NEGOTIABLE” and made payable to “Campion Centre of Ignatian Spirituality” debit my, Mastercard Visacard Name appearing on credit card: ________________________________________________ Expiry Date: / Signature:___________________________________ *Please note that credit card surcharge may incur.
Application-Form-Walking-with-Jesus-as-on-The-Road-to-Emmaus-2018.docx