FORRAS MISSIONS PARTNERSHIP FORM

(Please print, fill out form, and mail to IMPACT at P.O. Box 40090, Bellevue, WA, 98104)


Contact Information

Name: ______________________________________________________________________________________

Address: ____________________________________________________________________________________

City: ______________________________________ State: ___________________ Zip code: _______________

Home: (_____)_______________________________ Cell: (_____)_____________________________________

E-mail: _____________________________________________________________________________________



By Check

  1. Please make check payable to IMPACT.
  2. Attach a note stating "Forras Missions". Please do not write on the memo part of the check.
  3. Mail to IMPACT, P.O. Box 40090, Bellevue, WA, 98104.
  4. A monthly reminder will be sent via email.

By Credit Card

$50 $100 $250 $500 $1000 Other $_________

Monthly Quarterly Annual Single Gift

Credit Card Information

Visa MasterCard Other

__ __ __ __ - __ __ __ __ - __ __ __ __ - __ __ __ __

Expiration Date: __ __ / __ __

Name as shown on Credit Card: _________________________________________



Thank you for your continued support to our missions in Manila, Philippines!