To join The Atlantic District Mission Society, simply print this page (click File - Print at the top of your screen) complete and return to:

The Atlantic District
171 White Plains Road
Bronxville, NY 10708
Attn: Carol Mittelstaedt

 

[ ] I/We want to become a member of the Atlantic District Mission Society, and bring God's Word to countless people in the New York metro area.

Enclosed is my tax deductible donation of:
$50__ $100__ $250__ $500__ Other____

Name ____________________________
Address __________________________
City______________________________
State ___________ Zip ______________

Please make your check payable to
The Atlantic District (LCMS)

I would like to make a contribution via credit card:

Credit Card # ______________________
Exp. Date _________________________
Signature _________________________

[ ] Amex
[ ] Discover
[ ] MasterCard
[ ] Visa

[ ] My contribution is in honor/memory of a person(s) or event.

Person's name or event

__________________________

Please send an acknowledgement of this gift to:

Name ____________________________
Address __________________________
City______________________________
State ___________ Zip ______________

[ ] Please send me additional information on planned giving.
[ ] I/we wish our gift to be anonymous

Thank you for your support!