YES, I want to give monthly to Dollar-Help!
Please enroll me in the Dollar-Help Automatic Giving Option.

Follow these easy steps to sign up:

1. Fill out this form.
2. Print it out.
3. Mail your completed form with your signature to: Drawer 2, St. Louis, MO 63171

Dollar-Help Automatic Giving Option Enrollment Form (fill out, print & mail this form):

Yes, I want to give to Dollar-Help, and I don't want to forget. Please add the amount below to my gas bill each month. (Gifts must be made in even dollar amounts.)

$1  $2  $3  $4  $5  $10  $  Circle one or fill in the blank.
Name
Acct. Number
Address
City/ZIP
Signature
Date

Return this form to:
Drawer 2
St. Louis, MO 63171