THE GOSPEL STATION NETWORK - A non-profit organization 501(c)(3)
WHITE CROSS Request

Business/organization
Optional
Name *
Prefix
First *
Last *
Suffix
Mailing Address:
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Country
Phone Number

###
-
###
-
####
Email
Optional

SHIPPING COSTS

The postage costs us $7.50 for each cross. Please help us with the shipping costs if you can.
How many crosses do you want? *
I will help with the shipping cost: *
 I will send a check (address below) 
 I will send cash or money order (address below) 
 I will donate with my credit or debit card (type info below) 
 I cannot give at this time. 
I will donate this amount for the shipping:
Enter dollar amount
I will donate this amount so more materials can be bought to continue this project
CARD.NUMBER
(no spaces)
NAME
As it appears on the card
Exp Date

MM
/
DD
/
YYYY
Enter the last day of the month
Billing address
If different from the MAILING address above
Street Address
If different from the MAILING address above
Address Line 2
If different from the MAILING address above
City
If different from the MAILING address above
State / Province / Region
If different from the MAILING address above
Postal / Zip Code
If different from the MAILING address above
Country
If different from the MAILING address above

FEEDBACK:

I heard about the white cross offer: *
 On the radio 
 Word of mouth 
 Saw it on your Gospel Station website 
 Saw it on your Facebook/Myspace/Twitter 
 Read it in your email/ e-newsletter 
 Read it in your mailed out newsletter 
I listen to:
 Online Radio Stream www.thegospelstation.com 
 88.3 FM South Central Oklahoma 
 91.5 FM Henryetta OK 
 93.1 FM Enid OK 
 93.9 FM Kingfisher OK 
 94.7 FM Lawton OK 
 101.5 FM Oklahoma City OK 
 102.7 FM Paris TX 
 103.9 FM Bartlesville OK 
 104.3 FM Granite OK 
 105.1 FM Ada OK 
 AM 850 Forest MS 
 Other station -- please give city& state 
Tell these friends about the white cross offer:
(Name, email and address if possible)
Send info on The Gospel Station network of ministries:
 Yes 
 No 
Send info on your WORLD MISSIONS TEAM
 How to go on mission trips with them 
 How to support the team financially 
 How to provide materials the team needs 
 An overview of the mission team 
Contact me about how I can have my business or organization mentioned in radio spots:
 seasonally - mentioned with season or holiday greetings 
 to sponsor local sports broadcasts 
 to sponsor a live remote broadcast in my area 
 to support rodeo activities or cowboy church 
 to be a sponsoring church or organization 
 no thanks. 
Questions or comments:
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THE GOSPEL STATION NETWORK
PO BOX 1343
ADA OK 74821
1.800.557.8815
[email protected]