Follow these four simple steps when filling in your contribution form: |
- Select your pledge amount
- Complete your name and details
- Select your preferred method of payment
Option 'A' - Credit Card Direct Debit
Option 'B' - Bank Account Direct Debit
- Agree to the pledge amount by checking the yes "I agree Box"
and submitting the Form.
- Revival Flame Ministries will send you an Authorisation form via
your choice of e-mail, fax or post for you to return
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Note: all details will remain confidential |
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I pledge a monthly offering of |
$20 AUD
$50 AUD
$100 AUD
$500 AUD
Other |
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Total Amount |
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Please tick this box if you require a receipt
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Title |
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| First Name |
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| Surname |
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Address |
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Postcode |
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Phone No. (Home) |
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| Phone No. (Work) |
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Email |
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Credit Details |
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Credit Card |
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Name |
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Expiry Date |
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Credit Card Number |
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Total Amount AUS$ |
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