PARTNERSHIP WITH DAVE & BETH GOFF

___I/we will partner with the Goffs by investing ___________ per month.

___I/we will partner with the Goffs with a donation of _______________.
___I/we will partner with the Goffs by committing to faithful prayer support.

FINANCIAL CONTRIBUTIONS WILL RECEIVE A TAX DEDUCTIBLE RECEIPT AT YEAR'S END.
Cheques (made payable to ACOP).
Pre-authorized withdrawal must forward a blank cheque marked "VOID".
Please note date preferred as follows;___ 1st of each month or___I5th of each month.
Please indicate when donations are to commence _____/____/_____

Name (print)- Signature:______________________________

VISA___ MASTERCARD ___ AMERICAN EXPRESS___

Card #___________________ Card expiry date _____/____/_____
Cardholder name_______________________
Signature ____________________