Donation Form for Faith in Action, Inc
PO Box 7173
Winter Haven FL 33883

First Name____________________Last Name__________________________

Address_______________________ City_________________State______Zip__________

Phone (______)_________________ Fax (______)____________________

Email _________________@___________________

I would like my donation to be used for the following. If this need is met, I agree for it to be used where needed most:

_____ Missions needs

_____ Sponsor a Child @ $25 a month ____girl ____boy

_____Building Projects

_____Medical Needs

_____ Food Program (Help Feed a Family $5 a bag)

_____A onetime love gift

____ I would like to be a Faith partner for a year (check one below)

• _____$200 ____$500 ____$1,000 ____$2,500 ____Other

***Please Mail all Donations to
Faith In Action,
PO Box 7173 Winter Haven, Florida 33883