Monthly Gift
Amount:	Choose Below $20.00 $40.00 $80.00 $100.00
Other Amount (Please List):
One Time Gift
Amount:	Choose Below $25.00 $100.00 $500.00 $1000.00
Other Amount (Please List):
Contact information:
First & Last Name:	Mr. Mrs. Ms. Rev. Dr.
Email address:
Home Church:
Company/Business Name: Mailing Address:
City:
State:	South Carolina Armed Forces Europe Armed Forces Pacific Alaska Alabama Arkansas Arizona California Colorado Connecticut Delaware District of Colombia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Zip/Postal Code:
Country if other than the U.S.
Area Code & Contact Number
Comments:
Best way to contact you:	Email address Mailing address Phone
If by phone, what times during what days are best to call?