DONATION DATA SHEET

Make Check or Money Order Payable to: Progresssive House of Worship, Inc. or PHW    

Mailing Addresss: P.O. Box 9348, Newark, NJ 07104-0348              

Attention: The Jonah Project Fund 

As in the King James Bible, 1 Chronicles  29:9 "Then the people rejoiced, for that they offered willingly" 

AMOUNT OF DONATION: $_______________

Please Print 

NAME: ______________________________________________

ADDRESS: ___________________________________________

CITY: ___________ STATE: _________ ZIP CODE: ________

CONTACT NUMBER: (         ) _______ - ___________

This information above, will be used to mail back your receipt for tax purposes only. If you would like information about future events, include your E-Mail Address. Thanks for your generous donation. Your Friends in Faith.

E-MAIL ADDRESS: _______________________

DATE: ___________________