Yes! I want to sponsor a child!
_____ Child's code number. Please include all the digits of the code number, even if it begins with a zero. (If you have no preference of which child to sponsor, leave this blank.)
Please check the amount you can pay
|
____ |
I can contribute $10 a month |
|
____ |
I will pay for an entire year now ($120) |
|
$__________ |
If you wish to contribute a different amount, please record that amount in the blank to the left. |
Please check your preferred payment option below:
|
____ |
I will pay by check now (Make checks payable to "SHAMA Inc Kids") |
|
____ |
I will pay by check by this date: _______________________ (Make checks payable to "SHAMA Inc Kids") |
|
____ |
I would like to arrange monthly sponsorship by direct deposit to the SHAMA Inc Kids bank account from my bank. For more information about this, email j1chande@uwsp.edu. |
|
____ |
I will pay by credit card. (For information about how to do this, go to our web page at http://www.uwsp.edu/multicultural/shama/CreditCard.htm.) |
Contact Information:
|
Name |
________________________________________________________________ |
|
Address
|
________________________________________________________________ ________________________________________________________________ ________________________________________________________________ |
|
Phone number w/ area code |
|
| OR Email address |
Mail this form to:
Jagdish Chander, for SHAMA Inc Kids
2460 Crescent Court
Plover, WI 54467
Note: Sponsorship cannot begin until SHAMA Inc Kids receives the first payment.