Round Up for Project Share Authorization

If you would like to sign up for a Project Share Fund donation, please fill out the form below.

Customer Name: *

Account Number: *

E-mail: (For your protection, if email doesn't match your account, a representative will contact you for further verification) *

Service Address: *

Phone: *

I authorize Mason PUD 3 to bill my account in the following method for the Project Share Fund: (This authorization shall remain in effect until PUD 3 receives written notification from me to terminate this agreement. I understand that if my account becomes past due, this authorization becomes invalid.)

Choose ONE of the following: *

Round up my bill to the nearest dollar each month.
Bill my account monthly for the following amount:

I would like to support the Project Share Fund with a ONE-TIME donation:

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