Your Contact Information
Title_____ Name ___________________________________________
Address ________________________________________________________
________________________________________________________________
City ______________________________ State ______ Zip __________
Home Phone _____________________ Daytime Phone ________________
E-Mail Address ____________________________________________
Gift Amount $______________________________________
_________In Honor of and/or __________In Memory of
Title_____ Name ___________________________________________
Send Acknowledgement of my gift to:
Title_____ Name ___________________________________________
Address ________________________________________________________
________________________________________________________________
City ______________________________ State ______ Zip __________
Message about my gift __________________________________________
________________________________________________________________
Credit Card Information
(Visa/Master Card/American Express)
Your Name (as it appears on the card) _____________________________
Credit Card # _____________________________________
Exp Date _______/__________ (mm/yyyy)
"I will instruct you and teach you in the way you should go;
I will counsel you and watch over you." Psalms 32:8
