I would like to support Prison Fellowship Bermuda with a gift of $_____________.

_____ Cheque enclosed payable to Prison Fellowship Bermuda.

_____ Please bill my: _____Mastercard _____Visa _____American Express

Credit Card Number: _________________________________________

Expiration Date: ____________________________________________

Name on Card: ____________________________________________

Signature: _________________________________________________

_____ My employer will match my donation. The matching gift form is enclosed.

Please print the following information so we may correctly acknowledge your contribution.

Donor's Name: ________________________________________________

Address: _____________________________________________________

City: ________________________________________________________

Parish: ________________________ PostCode: ______________________

If outside Bermuda, please add
State/Province/County: ________________________

Zip or PostCode: ______________________

Country: _____________________________

Phone: ________________________________________________

E-mail: _______________________________________________________

Mail or bring your completed form to Prison Fellowship Bermuda, c/o The Office, 46 Par-la-Ville Road, Hamilton HM 11

Print this page
Click to print this page