SIGN UP FORM

We are asking for a small donation from anyone who wishes to partake in this program, this is in order to assure that this program will be continuously available for you and everyone else in the future.

Any additional donations we receive will go to mission trips and our tithing partner

Operation Underground Railroad.

SELECT AMOUNT:

Pay What you can:	Price
$5 Donation	$5
$10 Donation	$10
$15 Donation	$15
$25 Donation	$25
$50 Donation	$50

basic information:

Full Name *

Email Address *

billing:

Full Address *

City Name *

State / Province *

Zip Code *

Payment:

Credit Card Number*

Expiry*

CVC Code*

We respect your privacy. All donations are made through a very secure network.

Your credit card information is never stored in any way.

Confirm Signup

By clicking on 'Confirm Signup' you also confirm the amount you selected in

this order form in order to participate in the program.

SIGN UP FORM

SELECT AMOUNT:

basic information:

billing:

Payment:

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