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Choose the FCA Ministry you want to support:

In support of FCA Org : 10913100

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Ministry Address:	Tom Koubek
	FCA
	200 SE 55 Ave
	Ocala, FL 34480

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Special Instructions: (Optional)

I authorize Fellowship of Christian Athletes to transfer from my checking account or charge to my credit card account, on the 20th day of each month, the amount I have shown above. I agree to notify FCA by mail, fax, or E-Mail to change or cancel this agreement.

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Credit Card

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