Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

How do you wish to make your pledge?

Your commitment is an intention to give only. The amount of your gift can be changed at any time by contacting the church office. Pledge is for a 3 year time period.

$100 a month

$50 a month

$25 a month

$10 a month

Signature *

By typing your name here you acknowledge the information above is correct.

First Name

Last Name

Today's Date *

MM

DD

YYYY