Join With Vision America

I would like to join with Vision America by pledging my support � as a Patriot Pastor and/or through individual contributions, and/or in prayer as indicated below.�

While a financial contribution is not required to join in this effort with Vision America, it would be greatly appreciated.

If you would like to make an immediate financial contribution without filling out the form below via secure online credit card transaction click here.�

You may also call us toll free at 1-866-522-5582 to make a credit card contribution. A contribution via personal check may be made by mailing it to:

Vision America
4000 S Medford Ste 17E
Lufkin Texas 75901.

Entry fields preceded by an *asterisk are required information.

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*First Name:
*Last Name:
*Address:
Address (cont. if needed):
*City:
*ST:
*Zip Code:
*Email Address:
Phone Number: Phone Type:
Organization: (Church or other Organization if any)
My Title:
I am: (best description For multiple choices, Hold [CTRL] and Click)

�	YES! I would like to:
	Volunteer as a daily Prayer Warrior.
	Receive member communications
	Receive information from affiliates
	Support the ministry with a donation .
	Join as a Patriot Pastor
	Receive the Vision newsletter by mail (electronic version available as member communications).
��

�Send mail to [email protected]
�Copyright � 2004 Vision America
�
�www.visionamerica.us

Vision America
PO Box 10
Lufkin, Texas 75902
(866) 522-5582