Commitment Form

Name: Address: Email: Phone:

Do you attend a C&MA Church? (please circle) Yes - No

Thank you so much for your heart and commitment to us and the mission of Remember Nhu! We look forward to partnering with you and seeing God work through both what you and we give to Him! Please check all boxes below that apply.

Prayer Partner
I/We commit to praying for Peter, Cali and Remember Nhu.
We will keep you up to date with our prayer requests through email and our blog. You can visit our blog at: www.peterandcali.blogspot.com

Financial Partner
I/We commit to a one time gift of $ . for two years.

I/We commit to a monthly donation of $

If you would like Remember Nhu to automatically withdraw from your account for your monthly commitment, please fill out the information below. Would you like to receive receipts via email? (please circle) YES NO

Option One: Checking or Savings Account (please attach a voided check to this form for this option)
Account Type: Bank Branch Name: Branch Address:

Routing Number: Account Number:

Option Two: Debit or Credit Card

Account type (please circle): Debit Card Credit Card Card Number: Card Type (please circle): Visa MasterCard Discover Name as it appears on card:

Expiration Date:

CVV/CCID (3 digit number on back):

I (we) hereby authorize Remember Nhu and the depository institution named above to initiate electronic debit entries, and if necessary, credit entries to my account listed above. I (we) acknowledge that the origination of ACH transactions to my (our) account must comply with the provisions of U.S. law. This authority is to remain in full force and effect until Remember Nhu has received written notification from me of its termination in such time and manner as to afford Remember Nhu and the depository institution listed above a reasonable opportunity to act on it.

Print Name: Signature:

Date:

Mail this completed form to: Remember Nhu | P.O. Box 27000 | Akron, OH 44319