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  • STEP 1: Contact Information
    • First Name REQUIRED Please fill out this field. Please enter valid data.

      Last Name REQUIRED Please fill out this field. Please enter valid data.
  • Envelope # REQUIRED Please fill out this field. Please enter valid data.
  • City REQUIRED Please fill out this field. Please enter valid data.

    State REQUIRED AK AL AR AS AZ CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MH MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR PW RI SC SD TN TX UT VA VI VT WA WI WV WY Please fill out this field.

    Zip REQUIRED Please fill out this field. Please enter a zip code.
  • Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  • Working Email REQUIRED Please fill out this field. Please enter an email address.
  • STEP 2: Campaign Decision
    • Yes I will make my pledge today: Yes No
  • PRAYING. I am praying about my decision. Please call me at:
    (    ) - ___-_____
  • Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  • NO, I am unable to help. I will keep you in my prayers. Please check box
  • STEP 3: Gift Amount
    • Please select your best choice: REQUIRED $10 Weekly ($40 Monthly) for 3 years for a total of $1,440 $20 Weekly ($80 Monthly) for 3 years for a total of $2,880 $25 Weekly ($100 Monthly) for 3 years for a total pledge of $3,600 I would like to donate more $____ Monthly for 3 years . Please fill out this field.
    • $ Amount

      $________

      Please enter valid data.
  • STEP 4:
    • Form of Payment Check Visa/MasterCard Website
  • STEP 5:
    • I would like to pay my pledge Monthly Semi-Annually Annually

  Submit

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