Christian Healing Network Mission Medical Clinic (a 501-c-3 not for profit agency) Donation Form Please print  and include with your check made payable to  Mission Medical Clinic
Name:
Address:
City:	State:	Zip:
Daytime Phone:
Evening Phone:
e-mail:
I / We wish to help Heal the Sick in the Name of Jesus by supporting  the operational efforts of the clinic. Our donation of (please write in):   $______________ is enclosed.  Give What ever God lays on your heart.   Please contact Jack Holliday, CEO, at  (719) 219-3402  to discuss MAJOR GIFTS Bequests, Memorial Gifts, and Legacy Gifts are especially welcome.   (A Memorial Wall is in the planning stages.)
Mail this form with your donation to: Development Office Mission Medical Clinic 2125 E. La Salle Street Colorado Springs, CO 80909

 Our Mission: To Heal the Sick in the Name of Jesus Christ
Because we believe - we care. Because we care - we do.