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Please
check what applies:
Membership
[__] | Volunteer [__]
Name:_______________________________
Address:_____________________________________________________________________
____________________________________________________________________________
Telephone:
(Home)___________________________(Work)_____________________________
Gender:
M / F
Church
Affiliation:_______________________________________________________________
How
did you hear about IMD?
_____________________________________________________________________________
Type
of support:
[__]
Prayer
[__]
Monthly Support of $___________
[__]
One time support of $___________
[__]
Volunteer
Please
find enclosed with this application my support of $_______________.
I
will send support at a later time in the amount of $_______________.
Please
put me on your mailing list.
Yes[__]
| No [__]
Please
mail this form and your support to:
With
Our Hands Together Inc.
41-35 163rd St. Flushing, NY 11358
Thank
you for your support of our ministry. May the Lord abundantly bless
you as you give to Him.
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