Dear David

YES – I WILL SEND YOU TO EVANGELISE EUROPE & RUSSIA

__        I enclose my one time gift of $ _____________

__      I will give $ ___________ per month for one year.  Enclosed is my first gift.

Please use my Love Gift(s) as follows:

__       For the REVIVAL CRUSADES

__      Where needed most

Checks mailed to US address payable to Prophetic Vision                        

Fed ID #452-2050718                                                                                          

Credit Card or Debit Card payments

I wish to pay the sum of $ ____________________________

__ Credit Card               __ Debit Card

Please enter card number below:

__  __  __  __  __  __  __  __  __  __  __  __  __  __   __  __     

__ Amex      __ Visa     __ Master Card     __ Discover                      

Expiration Date ____________  Signature _____________________     

AUTOMATIC GIFT/CHARGE AUTHORIZATION

All information provided is held in the strictest confidence

Please complete in BLOCK CAPITAL LETTERS, CLEARLY

__ Yes, I would like to give a monthly gift of support automatically by having it deducted from the following Bank Card.

         __  MasterCard                    __  Visa                                __  American Express        __  Discover

Card Number __  __  __  __  __  __  __  __  __  __  __  __  __  __   __  __   Expiration Date _______________

Please PRINT your Name as it appears on the Card: __________________________________________________________

I am authorizing Prophetic Vision to automatically deduct $ ___________ each month from the above listed card.

Please start my deduction on the:  (Check One)     __  10th    or            __  25th of _____________ month __________ year.

Home phone:   (           )              -             Work phone:  (           )              -                Cell phone:    (           )            -              

Your signature: ______________________________________

Thank you for using this method to give.

Your regular, automatic, monthly support makes a constant and important difference to our on-going work of evangelism in Russia.

Return completed form to:

Prophetic Vision USA INC, PO Box 10565, Wilmington, DE 19850

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