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TO MAKE A DONATION, PRINT THIS PAGE, COMPLETE THE INFORMATION, AND MAIL THIS FORM TO THE CHURCH ADDRESS.
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 I want to donate to the
( ) --Worldwide Church operations or administration.
( ) -- Support of the Assembly of ___________________(identify the Assembly Coordinator, Priest or Priestess here:__________________________).
( ) -- Establishment of the Church endowment (savings/investment) program.
My name is: _______________________. My donation amount is: $_______USD
A receipt for my donation should be sent to the following address: _____________
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( ) Yes I would/ ( ) No I would not / like more information on the Church of Belief Science. My e-mail address is: __________________________________
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