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Please Print and complete all information
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I am a member
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Zip___________
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I am a visitor
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Address_________________________________
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Name___________________________________
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Credit Card#____________
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City____________
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State_______
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Home Phone______________________________
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Date____________
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Expire Date#______
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$_______
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Tithe
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$_______
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$_______
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Total
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Radio/TV
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$_______
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Pastor
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Building/Fund
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Church Name
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UPLOAD LOGO
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Check
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Cash
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Offering
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Children Church
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1234 Church St . Your City ST 12345
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www.yourwebsite.com (123) 1234567
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