Name: _____________________________________________________ Name (as you would like it to appear on card): __________________________________________________________ __________________________________________________________ __________________________________________________________ City ________________________________State_______Zip_________ Phone (Optional)____________________________________________ E-Mail (Optional)_____________________________________________ Annual Tithe $35.00 Additional Donation: $_____________ Total Enclosed $____________ Print out and mail with a Money Order to: P.O.Box 281 Salem, MA 01970 978-745-8668 TNW-SALEM@TNW-SALEM.ORG |