Use this form to make an online donation. Please fill in the areas at the bottom of the page with a $ amount or a "0" so we know where to credit your giving.  Thank you!

( * = required field )
First Name:  *  
Last Name:  *  
Organization:
Address:  *  
City:  *  
State:  *  
Zip Code:  *  
Phone:  *  
Email:  *  

Please select if you would like to make a one-time donation or an automatic recurring donation:
Amount ($):  *  
Payment Frequency:  *  
Start Date:  *   Calendar
No. of Donations:  *  

ADDITIONAL INFORMATION
Tithe Amount:
Minister ID Number:
Spouse Tithe Amount:
Spouse ID Number:
Missionary Itineration Offering (4% of offering):
Boys and Girls Missionary Challenge (BGMC) Amount:
Women's Ministries Amount:
Lake Placid Conference Center Amount:
Light For The Lost (LFTL) Amount:
Speed The Light (STL) Amount:
National Youth Ministry Gift Offering:
Indiana Advance:
Other Amount:
If OTHER, please specify:
Comments:

PAYMENT INFORMATION
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Credit Card Type:  *  


Credit Card Number:  *  
(xxxxyyyyzzzzaaaa) no spaces or dashes
Expiration Date:  *     (mm/yy)
Card CVV Code:  *   3 or 4 digit code
Enter Security Code:
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