PERSONAL INFORMATION:

Mr. Mrs. Ms. Rev. Dr.

Name

Position

Address

City

State/Country

Zip Code

Home Church

Telephone
-
Fax
-
Email

URL

MISSIONARY SELECTION:

Your monthly love gift will reach a native missionary with food, transportation, agricultural and housing needs:

• $50.00 will help a single native missionary.
• $100.00 will help a native missionary couple with one child.
• $150.00 will help a native missionary couple with three children.

1. Goa-Panaji District:

3 months 6 months 12 months
$50.00 $100.00 $150.00 to help as much as possible

2. Goa-Majorda District:

3 months 6 months 12 months
$50.00 $100.00 $150.00 to help as much as possible

3 months 6 months 12 months
$50.00 $100.00 $150.00 to help as much as possible

3 months 6 months 12 months
$50.00 $100.00 $150.00 to help as much as possible

3 months 6 months 12 months
$50.00 $100.00 $150.00 to help as much as possible

After receiving your form, an adoptive missionary profile, photos and instructions explaining how you may send your monthly contributions, will be mailed to you. You will receive a field report quarterly and a financial report every semester. All individual gifts are tax-deductible as allowed by law. Receipts will be expedited by the end of the year for tax purposes.

6. Use the space below for your personal comments: