By mail
        1.  Inform SAMS of your intentions by mailing this form the SAMS office.  Support may
        begin immediately and usually continues until termination of missionary service.

        2.  All gifts are welcomed, especially a
ONE DOLLAR A DAY contribution.
                 (  ) I/we will pray for Jack.

                As God enables, I wish to contribute:
                    (  )  $10 per month 
                    (   )   $30 per month -  ONE DOLLAR A DAY
                  (  )  $____________ per month
                              This support will begin with the month of __________ 20_____. 
                      (  )  $____________   one time gift.
        
                   (  ) I/we want to receive Jack's e.newsletter.
                      Your email:____________________________
            Make contributions payable to SAMS-USA and indicate Melvin in the
           memo line. Mail to P.O. Box 399, Ambridge, PA  15003.  A tax
          deductible receipt will sent for income tax purposes.  SAMS
            missionaries must raise their full support.

        Name: ___________________  __ ____________________________
        Address:_______________________                                          
        City______________________________________________________
        State ___________________                      __Zip ____               
        Phone____