Recurring Gift
Please print and complete form, filling in all information.
Mail the comleted form along with your check or money order to:
PDAP
1201 W. Texas
Ave.
Midland, TX 79701
| Contributor's Name(s) | |
| Address | |
| City | |
| State and Zip Code | |
| Daytime Phone | |
| Amount of MONTHLY Gift | |
| Reminder by mail or E-mail? | |
| E-mail(optional) | |