Partner Name: _________________________________________

Address: ______________________________________________

City _______________________, State _______, Zip ___________

Phone Number ________________________

E-Mail Address: _______________________

PLATINUM LEVEL

Enter Your Donation Amount Here: _________ * Minimum pledge $100

( ) Donation Only

( ) Donation with Partner Gift

Select Gift Type :

( ) Cassette Tape ( ) CD ( ) DVD ( ) MP3 (e-mail address required)

GOLD LEVEL

Enter Your Donation Amount Here: _________ * Minimum pledge $50

( ) Donation Only

( ) Donation with Partner Gift

Select Gift Type :

( ) Cassette Tape ( ) CD ( ) MP3 (e-mail address required)

SILVER LEVEL

Enter Your Donation Amount Here: _________ * Minimum pledge $25

( ) Donation Only

( ) Donation with Partner Gift

Select Gift Type :

( ) Cassette Tape ( ) CD ( ) MP3 (e-mail address required)

 

Mail form to:

Church In The Now Media
P.O. Box 80876
Conyers, GA 30013
Phone: 678-607-3113