----Printable Form For Mail and Fax----

The Community Presbyterian Church
145 Carletondale Road
Ringwood, NJ 07456
Tel: (973) 962-7431   Fax: 973-962-6342

Date: ____________________

Name: ____________________________________________________________________

Address: __________________________________________________________________

City: ______________________________________________________________________

State: ________________________________Zip:__________________________________

Country: ___________________________________________________________________

Telephone: (____)     E-mail Address____________________________________________

Method of Payment:

VISA ___

MasterCard___

American Express ___

Discover ___

Credit Card Number: _____________________________________

Credit Card Expiration Date: __________________

Signature (if printing form to mail or fax): ___________________________________________

Monthly Donation of $________ (We will automatically process this amount the 1st of each month with the above credit card)

One Time Donation of $_________ .

OR

_____Check or money order (if mailing order with printed order form) Payable to: Community Presbyterian Church
(Please note "Online Ministries" on your check)