ABOUT YOU ...

Name:
Address:
Address:
City:
State:
ZIP:
Phone: (include area code)
Email: (user@server.com)

YOUR PLEDGE ...

Monthly Pledge Partner Amount:	$
Please commit to support HEARTLIGHT on a monthly basis with your pledge of any amount. A monthly pledge is considered on-going "Until Jesus Comes" or until you change or cancel it. Our suggested pledge amount is $20 per month, but any amount is accepted and appreciated.

COMMENTS / REQUESTS ...

Will you take a few moments to tell us how HEARTLIGHT has affected your life?

Would you like to add a dedication to a loved one? We'll be posting a listing of all dedications online soon.