Angels of Appalachia
Partnership Form
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q YES! I’m ready to make a difference in the lives of people in
Appalachia by becoming an Angel of Appalachia.
I’ve enclosed my first monthly
partnership gift of:
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q $15
q $20
q $30
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q $40
q $50
q Other $___________
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________________________________________________
Name
________________________________________________
Address
________________________________________________
City State Zip
________________________________________________
Phone Email
You will receive monthly reminders. CAP is a 501(c) 3 charity. Your
gifts are tax deductible.
Please return this form with your first monthly gift to:
Christian Appalachian Project
DEVELOPMENT OFFICE
P.O. Box 511, Lancaster, KY 40444-0511
4611-9
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q I’d like to make my monthly gift by credit card:
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q American Express
q VISA
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q MasterCard
q Discover
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_________________________________________________
Card Number
_________________________________________________
Expiration Date Security
Code*
_________________________________________________
Cardholder’s Name
_________________________________________________
Cardholder’s Signature (Required)
Security Code*: What is it?
When using your credit card,
please include your security code. It’s
the 3 digit number printed on the signature panel on the back of your VISA,
MasterCard, or Discover card. On
American Express cards, it’s a 4 digit number printed on the front of the card.
