THE GOSPEL STATION NETWORK - A non-profit organization 501(c)(3)

WHITE CROSS Request Receive a small white cross to display your faith. Provided by The Gospel Station

Business/organization

Optional

Name *

Prefix

First *

Last *

Suffix

Mailing Address: *

Street Address *

Address Line 2

City *

State / Province / Region *

Postal / Zip Code *

Country *

Phone Number

### - ### - ####

Email

Optional

SHIPPING COSTS The postage costs us $10.00 for each cross. Please help us with the shipping costs if you can.

I will help with the shipping cost: *

I will send a check (address below)   I will send cash or money order (address below)   I will donate with my credit or debit card (type info below)   I cannot give at this time.

I will donate this amount for the shipping:

Enter dollar amount

I will donate this amount so more materials can be bought to continue this project

CARD.NUMBER

(no spaces)

NAME

As it appears on the card

Exp Date

MM / DD / YYYY Enter the last day of the month

Billing address

If different from the MAILING address above

Street Address

If different from the MAILING address above

Address Line 2

If different from the MAILING address above

City

If different from the MAILING address above

State / Province / Region

If different from the MAILING address above

Postal / Zip Code

If different from the MAILING address above

Country

If different from the MAILING address above

FEEDBACK:

I heard about the white cross offer: *

On the radio   Word of mouth   Saw it on your Gospel Station website   Saw it on your Facebook/Twitter/Instagram   Read it in your email/ e-newsletter   Read it in your mailed out newsletter

Tell these friends about the white cross offer:

(Name, email and address if possible)

Send info on The Gospel Station network of ministries:

Yes   No

Questions or comments:

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THE GOSPEL STATION NETWORK
PO BOX 1343
ADA OK 74821
1.800.557.8815
email@thegospelstation.com