Sponsorships* Sponsorships* $1,800 $1,000 $720 $500 $360 $250 $180 $100 $72 $50 $36 Other

If Other: $

Student Sponsor Student Sponsor I would like to sponsor a student for one year - $895

Family Education Family Education I would like to sponsor a family education program - $1,800

Month of Learning Month of Learning I would like to sponsor a month of learning - $2,500

Name*

Address*

Postal Code*

Phone Number*

Donation Frequency* Donation Frequency* One Time Donation Monthly Donation

1 Time For $_ or Monthly For $_ for _Months

Credit Card* Credit Card* Visa MC

CC #*

Exp. Date*

CVV #*

Signature (Name)*