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DONATION FORM FOR THE MARRIAGE BED, INC.

All information is optional, but we need a name and address if you wish to receive a year end donation confirmation for your taxes.

Name: ___________________________________________

Address: _________________________________________

City: __________________________ State: ____________

Zip/Postal Code: ________ Country: __________________

Amount enclosed: $ _______
One time gift ___ Recurring gift ___

E-mail address ___________________________________

__ Check here to receive confirmation by e-mail.
__ Check here if you do NOT want a donation confirmation – no mail will be sent.

Comments:

Prayer Request:

mail to:
The Marriage Bed, Inc.
4641 Lyons Hill Road

Springdale, WA 99173

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