Events

First Name:
Last Name:
Company/Organization:
Title:
Address 1:
Address 2:
City:
State/Province:
Zip:
Country:
Phone:
Email:
Apply To:
   
Type of Donation
if memorial:
 
name of deceased
send notification to
(name)
  (address)
   
if tribute:
  
name of person
occasion
send notification to:
(name)
  (address)
 
Amount of donation:
$ 10.00
$ 25.00
$ 50.00
$ 100.00
$ 250.00
$ 500.00
$ 1,000.00
$ 2,000.00
$ 3,000.00
$ 4,000.00
$ 5,000.00

 $ 
   
frequency of gift :
one time monthly
  If monthly:  Please charge my credit card for the amount specified each month beginning on the  5th 25th

This will remain in effect until I notify Scott Dawson Evangelistic Association to end the agreement, which can be done at any time by calling the SDEA office at 205-833-9163
   
type of card :
Visa
MasterCard
American Express
Discover
Credit Card Number :
Expiration Date :
 
Name on Card :
   
Additional Comments:
   
 

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