Husband	Wife
Title	Title
First Name	First Name
Last Name	Last Name
How you prefer I refer to you	same as husband

Home Information
Street
City	State	ZIP+4
Phone
E-mail address

His Work Information		Her Work Information
Company		Company
Street		Street
City		City
State	ZIP	State	ZIP
Phone		Phone
His work E-mail		Her work E-mail

Family Information
Husband Birthday	Children	Birthday
Month/Day/Year	Name	Month/Day/Year
/ /		/ /
Wife Birthday Month/Day/Year		/ /
		/ /
/ /		/ /
Anniversary Month/Day/Year		/ /
/ /		/ /

Giving Information

Sign me up! I want to commit/change my commitment to giving per month quarter year to your ministry.

I will send a check.

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I've got some friends I would like to share your ministry with. Please call me with more information.

Mail Information

Send Prayer Letter to home address    His work    Her work

I would be interested in receiving your prayer letter electronically.

Please send urgent updates/prayer requests via e-mail.

Remove me from Campus Crusade for Christ general mailing list.

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Other Information You Want Me to Know

If you do not get a confirmation page after sending this form please e-mail me michael@hottman.com