IBA INSTITUTE for Biblical Apologetics, Inc. (530)432-9484 (877)202-1817 PO Box 2838 GRASS VALLEY CA 95945 Support IBA by switching to LifeLine!! Help reach cults for Christ and give an answer!! Connecting People, Changing Lives. Call 1-809-365-1658 Today! ____ YES, I want LifeLine to be my long distance phone company! MAIL THIS FORM IN TODAY PLEASE PRINT ALL INFORMATION TO EXPEDITE THE SIGN-UP PROCESS, CALL 1-800-805-8868 Or Visit our website at: www.lif.line.net ___________________________________________________________________________ Name (As shown on your local phone bill) ___________________________________________________________________________ Address City State ZIP ___________________________________________________________________________ Telephone Number Additional Telephone Number ___________________________________________________________________________ Fax Number E-mail ___________________________________________________________________________ Present Long Distance Company Present Local Phone Company Designated Charity: Institiute for Biblical Apologetics, Inc. (IBA) P.O. Box 2838 Grass Valley, CA 95945 ___________________________ NPO# PLEASE SELECT A LIFELINE RESIDENTIAL CALLING PLAN Calling Plan Monthly Fee Sunday Mon - Sat (Check one of the boxes below) per minute* per minute* ____ LifeLine Sunday Connections $5.95 4.9 ˘ 6.9 ˘ Toll free Calling Card 9.9 ˘ 9.9 ˘ _____ LifeLine Connections $3.95 8.9 ˘ 8.9 ˘ _____ LifeLine Freedom None 14.9 ˘ 14.9 ˘ * All rates quoted reflect state-to-state calls only. Additional surcharges may apply. + Includes discounted in-state, local toll and international rates. Save an additional $1.00 on your monthly fee by charging your account to your credit card. In State/Local Toll (check one of the boxes below) I want LifeLine as my: ____ Long distance and local toll provider (where available) ____ Long distance provider Yes, I agree to become a LifeLine long distance customer. I authorize AMERIVISION COMMUNICATIONS, INC. (LIFELINE) to notify my local telephone company that I am choosing LifeLine Communications as my primary carrier for long distance service as indicated above. I certify that I am 18 years of age and authorized to designate the primary carrier for each telephone number listed on this form, understand that I can only have one primary carrier for each of these services per telephone number listed, and my local telephone company may apply a fee for this change. if a fee is charged, LifeLine will reimburse that amount. If I live in California or Florida or if I send this information via facsimile, I also understand an independent certification company will be calling on behalf of LifeLine to confirm my request. _________________________________________________________________________ Authorized Signature I have read and understand this agreement (must be at least 18 to apply) Send to: Amerivision Communications, Inc. P.O. Box 12980 Oklahoma City, OK 73157- 9960 Rev. Dan R. Schlesinger MA. M.Div. Defending the Faith for the Cause of Christ” LifeLine communications - NCR LD.GORP1 .08/24/2001. MEMBER- EMNR