Donation Pledge Form - DOC by JLHXlGjv


									          I want to help children and families in Juarez
Name: ________________________________________________________________

Address: ______________________________________________________________

City: ________________________ State:_____________ Zip: _________________

Home phone: ___________________________Alt. Phone: ______________________

Email: __________________________________ Church: ______________________

                             I can help in the following way(s):
$1000 per year for next 3 years
Break the poverty cycle with education for the children in Juarez

$500 per year for next 3 years
Help families have access to basic medical care

$250 per year for next 3 years
Provide adult education program

Contribute $ __________ per year for next _______ years.

Please contact me. I have ideas to share.                 Please e-mail me the newsletter

                              I would like to make my gift via:

Check (payable to Arrow Outreach)

My company will match my gift.

My preferred payment plan is:                Monthly        Quarterly         Annually

Please send my receipts by e-mail.                    Send only an annual receipt.

Arrow Outreach is a nonprofit 501(c) 3 charitable organization. All gifts are tax deductable as allowed by
law. By signing this form, I am making a commitment to Arrow Outreach for the set amount indicated
above. I understand that I may cancel this commitment or adjust the amount at any time by contacting
Arrow at: 903-963-7672.

Signature:________________________________ Date: ____________

Please mail completed form to: Arrow Outreach
                               8442 FM-16
                               Van, TX 75790-2630

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