Take-A-Day web page - click here or type the URL in your browser - http://cocn.org/takeaday.htm
 
(Please cut out this box and mail with your communication)
TAKE-A-DAY MAIL RETURN FORM 
(Please PRINT Clearly) 
Date of your choice Your Name:
Address: City:
State: Zip:
E-Mail Address: Home Church:
Other Dates I would like to have: Other Dates  : 
Total Number of days____X$50.00 = $_____________ Total  
Tell us who this is for and what the occasion is...
    Person's Name & Date
     Relationship:
  * Self___  * Spouse___ * Son___  * Daughter___  * Grandson___ * Granddaughter___  * Grandfather___
* Mother ___  * Grandfather___  * Grandmother___  * Other___  _____________________Who?
  * Self___  * Spouse___ * Son___  * Daughter___  * Grandson___ * Granddaughter___  * Grandfather___
* Mother ___  * Grandfather___  * Grandmother___  * Other___  _____________________Who?
  * Self___  * Spouse___ * Son___  * Daughter___  * Grandson___ * Granddaughter___  * Grandfather___
* Mother ___  * Grandfather___  * Grandmother___  * Other___  _____________________Who?
  * Self___  * Spouse___ * Son___  * Daughter___  * Grandson___ * Granddaughter___  * Grandfather___
* Mother ___  * Grandfather___  * Grandmother___  * Other___  _____________________Who?
  * Self___  * Spouse___ * Son___  * Daughter___  * Grandson___ * Granddaughter___  * Grandfather___
* Mother ___  * Grandfather___  * Grandmother___  * Other___  _____________________Who?
  * Self___  * Spouse___ * Son___  * Daughter___  * Grandson___ * Granddaughter___  * Grandfather___
* Mother ___  * Grandfather___  * Grandmother___  * Other___  _____________________Who?
For additional listings please use the back of this form
I would like to receive my Free Gospel CD Newsletter by: (Check One) E-Mail___   Regular Mail___

I am enclosing a check for my opportunity to Take-A-Day.
Check # _____________ in the amount of $__________________.

____ I want to help but cannot send funds at this time.
Please send me a reminder ONE MONTH before my unpaid dates.

(Please us the back of form for additional comments)

Mail To: Church of Christ/North - Attention Free Gospel CD Ministry
3401 North Market Street - Shreveport, Louisiana - 71107