Please Print Out and complete this form and send to:

Name:_________________________________________________________________

Address:_______________________________________________________________

Phone Number:_______________________________________________________

I would like to sponsor a boy, ____________ girl, ___________ either sex, ______________

(  ) Here is my $25.00 (suggested amount), or $__________________for the first month.

(  ) I am unable to sponsor a child a this time, but would like to donate $___________________.