Name of donor: _________________________________________________

Addres of donor: ________________________________________________

City: __________________________________________________________

State: ______________________ Zip + 4: _________________________

Amount desired to give : $_____________________________

Starting when? ________________________________________________

How often will money be sent to Awana Clubs International?
[ ] Monthly [ ] Quaterly [ ] Other _______________________

Name and address of your church:________________________________

_______________________________________________________________

Signature: _________________________________ Date:_______________

Make checks payable to Awana Clubs International and send to the address
listed below. Please include this form. Monies given are forwarded to the
missionary in entirety. Nothing is deducted for administrative expenses.
This support statement is not a binding agreement.

Awana Clubs International
One East Bode Road
Stereamwood, IL 60107-9951