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Donation Form

Flying Mission USA is a non-profit organization that partners with Jon and Katrina Baines to provide financial support through donations. Donors can choose to give one-time gifts, regular monthly donations, or set up automatic credit card billing. The form requests contact and payment information to facilitate the desired type of financial commitment to Flying Mission USA and the Baines' mission work.

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baines07
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© Attribution Non-Commercial (BY-NC)
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96 views1 page

Donation Form

Flying Mission USA is a non-profit organization that partners with Jon and Katrina Baines to provide financial support through donations. Donors can choose to give one-time gifts, regular monthly donations, or set up automatic credit card billing. The form requests contact and payment information to facilitate the desired type of financial commitment to Flying Mission USA and the Baines' mission work.

Uploaded by

baines07
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Flying Mission USA

1698 Airport Road N Suite 1


Worthington, MN 56187
507-376-9480

I/We desire to commit to a partnership with Flying Mission and Jon & Katrina Baines!
Name __________________________________________________e-Mail ______________________________________________
Address________________________________________________ City, State Zip _______________________________________

I/We will commit to financially support Jonathan & Katrina through:


automatic donations from my credit card (see below)
regular monthly gifts of $__________________ (monthly receipts will be sent with return envelopes)
a cash gift of $__________________ (enclosed)

Please make checks payable to Flying Mission USA.

Flying Mission USA, Inc. is a 501c3 Non-Profit organization; contributions will be issued a tax deductible receipt.
Automatic Credit Card Billing
If you would like to enjoy the convenience of automatic billing, simply complete the information below and sign the
form. All requested information is required. Upon approval, we will automatically bill your credit card for the
amount indicated and your total charges will appear on your monthly credit card statement. You may cancel this
automatic billing authorization at any time by contacting us. This form may also be used for one-time donations.

Credit Card Payment Information


I authorize Flying Mission USA to bill the card listed below as specified:
Amount:

$_____________________

For Automatic Billing:


Start billing on:

Frequency (check only one):

Weekly
Quarterly
One-time gift

Semi-Monthly
Semi-Annually

Monthly
Annually

____________/____________/____________

End billing when:

Customer requests cancellation or


Specific date: ____________/____________/____________

Flying Mission USA accepts the following credit cards: Visa, MasterCard, Discover & American Express
Credit card type:

Credit Card number:

Expires

___________________________

_________________________________________________

____________/____________

Cardholders name (as shown on credit card):

Cardholders Zip code (required)

Phone Number

_______________________________________________

____________________________

__________________________

Customers signature:

Date:

_______________________________________________________________________

__________/__________/___________

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