Donation Form

BECOME A CHANGE AGENT

Man in the Mirror Change Agents are a special group of partners who commit to giving $1 or more a day to change lives and build the kingdom of God—whether it’s given as $30+ a month, $90+ a quarter, or $360+ a year.

As a Change Agent, you receive special discounts on resources and training, encouraging stories about how your gifts are being used, insider updates, and more.

Change Agents truly are the backbone of our ministry; God is transforming lives in partnership with YOU!

To give as a company, church, or non-profit organization, please click here.

Contact Information

First Name

Last Name

Country

Address

Address 2

City

State/Province

Zip/Postal Code

Primary Phone

Receipt Preference

Payment Information

Payment Options

Credit Card Information

Card Holder Name

Card Number

Expiration Date

Security Code

Billing Address

Same As Above

Address

City

State/Province

Zip/Postal Code

Privacy Policy
We take precautions to protect your information. We collect credit card or bank account information, names, addresses, and other data related to your transaction when you make a payment through our site. We use this information to process your payment.

Terms/Conditions
By submitting your payment, you authorize us to charge the account above for the amount specified in the Gift Amount field. Account information for Recurring Pledges/Monthly Giving is encrypted and stored securely via SafeSave™ for automatic processing of your future payments. Notify us at anytime if you wish to discontinue your pledge.