Donation Form

Bold Fields are Required
Please Choose:	CREDIT CARDBANK DRAFT
Contact Information:
Prefix:		First Name:
Middle Name:		Last Name:
Address:
City:		State/Prov:
ZIP/P.Code:		Country:
E-Mail:		Phone:
Select Gift Frequency:
	One-time gift in the amount of: $
	Monthly gift in the amount of: $ to be deducted on the 15th of each month.
Gift Designation:
	Touching Tomorrow Campaign Annual Fund (our greatest need) Arizona Campus Annual Fund Rocky Mountain Campus Annual Fund Trustee Boardroom at the Ontario Campus Henry Blackaby Prayer Room at the Ontario Campus Rocky Mountain Campus Endowment Challenge Pacific Northwest Campus Annual Fund
Credit Card Information:
Name on Card:		Card No:
Card Type:	MasterCardVISA	Security Code:
The 3-digit security code appears at the right of the signature box.
Exp. Month:		Exp. Year:
Please contact me to discuss other gift options: Wills/Estates Stock Real Estate Real Property Other

Questions? Please call Ben Skaug toll free at 888-442-8709.