Support

Global Health Outreach to Chennai, India: October 6-21, 2012

Yes, I would like to support Scott & Martha Kehl during their GHO mission to Burkina Faso, West Africa

_____ in prayer before and during the trip.

_____ in prayer and with a $_________ donation toward Scott and Martha’s project.

Name:       ____________________________

Address:    ____________________________

City:           ___________________________ State:__________

ZIP:             ___________________

If you wish to be added to any e-mail lists for the trip, then please include your e-mail address:   _____________________________________________________________________

Donation Form:

____ Pay by check – Please make checks payable to CMDA/GHO and return with this slip.

____ Pay by credit card:  _______-_______-_______-_______

Visa / MC / AmEx    Exp.Date: _______/_______

Name on Card:____________________________

Address:_________________________________

City:___________________________ State:____

ZIP:___________________

Please mail this slip to:  Scott and Martha Kehl, 40155 Lucinda Court, Fremont, CA 94539; we will forward them on to GHO.   Funds not needed for this trip will be used to support other GHO activities. All gifts are charitable contributions deductible to the extent permitted by § 70 of the Internal Revenue Code. You will receive a receipt from the Christian Medical and Dental Associations reflecting your donation.

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