Monthly Auto Debit Bank Program
Foundation of Human Understanding • PO Box 1000, Grants Pass, OR 97528
Fax: 1-541-956-6705 •  Email:

The minimum monthly donation is $5.00. The amount you choose will be debited from your account on the 15th of each month. You can change the donation amount or cancel at any time by contacting the foundation:
click here to contact us.

3 Easy Steps
1. Complete the form below and then print.

2. Sign and date it.

3. Return the form to FHU with a "voided check"
   (write "void" across the check, this gives us the bank's details).

Zip Code:

I (we)______________________________________ authorize the Foundation of Human Understanding to initiate debit entries on the 15th of (month)_____________for a monthly donation in the fixed amount of...

$200      $100      $75      $50      $25      $10      $5

other (enter amount) my/our checking account. I (we) authorize my (our) financial institution to accept debit entries initiated by the Foundation of Human Understanding and to deduct the amount specified above from my (our account). This authorization is to remain in effect until the Foundation of Human Understanding has received written notification from me (us) of its termination. I (we) understand that I (we) have the right to stop payment of a debit entry by notification to the Foundation of Human Understanding prior to charging my (our) account up to 15 days following issuance of bank statement or 45 days after the account is charged, whichever occurs first.
Account #________________________________

Name and Address of financial institution


Signature: _______________________________

How do you listen to Roy?
Radio Station (enter station call letters)
Web Site