PWT Donation Name* First Last Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email* Phone*Donation to Public Witness Team*I wish to contribute this amount to the Public Witness Team: This donation is:in honorin memoryin celebrationofSubtotal $0.00 I will be paying via*Credit CardCheckMake your check out to "NT-NL Synod, ELCA" and put “Public Witness” on the memo line, then mail to 680 Copper Canyon Rd, Argyle, TX 76226.Optional I would like to offset the cost of the credit card processing fee (2.9% + $0.30) Processing fee Price: $0.00 Total $0.00 Credit Card* American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20212022202320242025202620272028202920302031203220332034203520362037203820392040 Expiration Date Security Code Cardholder Name