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Yes Lord Deliverance COGIC

739 7th Street

Chipley, Fl. 32428

FIRST NAME:
LAST NAME:

ADDRESS:

CITY:
STATE: ZIP:

COUNTRY:
PHONE: EMAIL:

Tithe: $ Youth Ministry: $

General Offering: $ TV Ministry: $

Building Fund: $ Audio/CD: $

Missions: $ Video/DVD: $

Other (Specify): $ Describe "other":

Total Amount: $

Card Holder's Name: (as it appears on your card)

Credit Card Number: (no dashes or spaces)

Expiration Date: (MMYY)

Credit Card Code:

Yes Lord Deliverance COGIC is a

registered 501(c)(3) nonprofit organization.

All donations are tax deductible.

Remember, the more you give the more we can do!

Thank you for your generous donations. All donations will be acknowledged.