The one by One Parish Campaign Account Withdrawal Form

Thank you for your support of the one by One campaign. To submit a withdrawal from your parish one by One account please fill out the form below. Once the form is submitted, we will process your request. Please know this process may take up to 10 to 14 business days for you to receive your check.

If you have any questions, please contact Jared Stroik, Relationship Manager, at 877-500-3580 ext. 8155 or 920-272-8155, [email protected].

Date
Month
Day
Year
Parish Name*
Parish Mailing Address (PO BOX Preferred)*
PO BOX or Street Address Address Line 2 City ZIP Code
Parish Contact Person*
First Last
Phone
Email*
How many requests would you like to make?
Requested Amount #1*
Purpose of the Request #1*

Please share how your parish would like to use the funds. Include the parish one by One campaign case element your request will address.
Requested Amount #2
Purpose of the Request #2

Please share how your parish would like to use the funds. Include the parish one by One campaign case element your request will address.
Requested Amount #3
Purpose of the Request #3

Please share how your parish would like to use the funds. Include the parish one by One campaign case element your request will address.
Requested Amount #4
Purpose of the Request #4

Please share how your parish would like to use the funds. Include the parish one by One campaign case element your request will address.
Does your project require a quote?
- Yes
- No
Project Quote if required
Accepted file types: jpg, tif, png, pdf, Max. file size: 50 MB.
Please provide any comments or notes about your request(s) below.
Pastor/Pastoral Leader Name*

Print Name
Pastors/Pastoral Leader Approval Signature
Please upload a signed document approving the request and amount needed with the pastor/pastoral leader's signature on the document.
Drop files here or

Accepted file types: pdf, jpg, tif, Max. file size: 50 MB, Max. files: 5.
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The one by One Parish Campaign Account Withdrawal Form

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