AUTHORIZATION AGREEMENT FOR

AUTOMATIC MONTHLY DONATION

Name: ________________________________ When they tell

Phone: ________________________________ you that
Address: ______________________________ abortion is a
______________________________________ matter just
City, State, Zip:_________________________
E­Mail:________________________________
between a woman
and her doctor . . .
By Bank Draft
FINANCIAL INSTITUTION:
_____________________________________
CHECKING ACCOUNT NUMBER:
_____________________________________
INFORMATION
ROUTING NUMBER:
_____________________________________ ABOUT
(Please attach voided check)
PLM
By Credit Card
Visa MasterCard
Card
Number:_______________________________

Exp. Date:___/___ Security Code:______

I hereby authorize the Financial Institution named they're

above to pay my monthly $_______________ forgetting
donation charging each payment to my account and to someone.
make that donation payable to the order of PRO­LIFE
MISSISSIPPI. I agree that each payment shall be the
same as if it were an instrument personally signed by
me. This authority is to remain in effect until revoked
by me in writing. In addition, I have the right to stop Pro­Life Mississippi
payment of a charge by timely notification to my 114 Office Park Plaza, Suite B
Financial Institution prior to charging my account. I Jackson, MS 39206
understand, however, that both the Financial 601­956­8636 Working and praying
Institution and PRO­LIFE MISSISSIPPI reserve the 601­206­1233 (fax) to make Mississippi the first
right to terminate this payment (or my participation plm@prolifemississippi.org abortion­free state in the U.S.
therein). www.prolifemississippi.org
SIGNATURE: ________________________
DATE: ___/___/___
PRO­LIFE MISSISSIPPI,
one of the state's oldest pro­life groups, was
established in 1979 as Right to Life of Jackson.
To reflect our state­wide mission, the name was
changed to Pro­Life Mississippi in 2003. We
are a Christian educational organization based
in Jackson, Mississippi with a statewide
membership. We are an autonomous group that
works closely with other Mississippi pro­life
leaders and ministries, as well as with numerous
national pro­family groups, including
Americans United for Life, Focus on the
Family, Concerned Women for America,
American Family Association, Christian Action
Council, and others.
We are a tax exempt, non­profit corporation
funded by donations from pro­life individuals,
churches, community organizations, and
businesses.
Mission Statement:
PRO­LIFE MISSISSIPPI is an organization of
diverse and caring Christians. We are drawn
together by our commitment to the sanctity of
human life from fertilization to natural death.
On behalf of those who cannot speak for
themselves, we are a voice against abortion,
infanticide, and euthanasia in Mississippi.
Our mission is to reach the state with the truth
about these life issues by providing educational
material and events in an effort to foster a
sanctity of life ethic in Mississippi. Our
secondary mission is to take the pro­life
message directly to those who threaten innocent
human life.
We feel the key to the success of our mission is
to motivate the churches of Mississippi into
taking action against these heinous sins.
ANNUAL EVENTS Ways To Support The Work Of
Pro­Life Mississippi
•Candlelight Prayer Vigil for the Unborn
•Annual Spring Banguet and Silent Auction
•Educational booth at MS State Fair and church •Come to the abortion clinic to pray
fairs
•Pray regularly for Pro­Life Mississippi
•Walk 4 Life
•Biking for Babies
•Be a Pro­life representative for your Church
•National Day of Remembrance
to Pro­Life Mississippi
•Life Chain
•40 Days for Life (Spring and Fall campaign) •Volunteer as a Sidewalk Counselor
ONGOING ACTIVITIES •Become a Board Member of Pro­Life
Mississippi
•Sidewalk counselor classes for volunteers
(contact our office for dates and times) •Participate in 40 Days for Life
•Provide literature for volunteer sidewalk
counselors.
•Volunteer/Participate in if Chain
•Resource Center open M­F 8:30 ­ 4:30
•Monthly newsletter with MS pro­life
information. •Volunteer/Participate in Walk 4 Life
•Email updates of MS pro­life news.
•Participate in Annual Candle Light Vigil
•Speakers for religious and civic organizations.
•Referrals of resources for women who choose
life. •Volunteer/ Participate in Annual Spring
Banquet & Silent Auction
OTHER AREAS OF ACTIVITY
•Volunteer to help work our Annual State Fair
Booth
•Physicians For Life Mississippi
•Pastors for Life
•Volunteer/Participate in National Day of
ACCOUNTABILITY Remembrance
•Oversight by Board of Directors •Sponsor a pro­life billboard
•501(c)(3) Tax Exempt Status
•Registered with MS Secretary of State •Sign up to receive our E­Newsletter
FUNDING •Make an Annual or Monthly Donation.
•Donations from businesses, individuals, and churches
•Average Annual Budget: $70,000.