___Other $____________
___$1000
___$500
___$250
___$100
___$50

___Enclosed is my tax deductible gift made payable to Food, Land & People

___Please charge my gift to my credit card MasterCard Visa

Charge this amount monthly over _____ months one time only

Card Number_________________________________________________________

Cardholder Name_________________________________________________________

Signature_________________________________________________________

Expiration Date_________________________________________________________

Charge this amount:$________________     ___monthly ___one-time only

Name_________________________________________________________

Address_________________________________________________________

City____________________________ State________ Zip___________

Phone___________________________

Fax___________________________

E-Mail_________________________________________________________

Please send payment to:

John Davis
65 Poinsettia Road SE
Scio, OH 43988

For additional information, please contact:

Christopher Williams - FLP USA Steering Committee Chairperson
PO Box 7600
Chandler, AZ 85246-7600
Telephone: (480) 963-7959
Fax: (480) 963-0187
info@foodlandpeople.org

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