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AWAKENING — Pledge Form
This is Step 1: this form only collects your information, it does not collect a payment—you will still need to make your first payment (instructions after you submit this form).
Fields marked with * are REQUIRED
Name:
*
First
Last
Address:
*
City, State, Zip:
*
Email:
*
Phone:
*
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Pledge Amount:
(This form only collects information so we can thank you—the next page will instruct you on making your first payment.)
Please select
$50.00/month
$75.00/month
$100.00/month
$250.00/month
$500.00/month
$1,000.00/month
Other amount (enter below)
Choose your pledge amount from the drop down,
OR enter an Other Monthly Amount below.
or Other Monthly Amount:
$
Dollars
.
Cents
Payment Option:
*
Monthly check
Automatic online banking payment
PayPal (from AWAKENING website)
Comments/Instructions:
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