HOPEH Sponsorship Program 2011-2012
First Name
*
Middle Name
Last Name
*
Organization Name
Address
*
Address 2
City
*
State
*
Zip
*
Email
*
Phone Number
*
Best time to call
*
Morning
Afternoon
Evening
Gender
*
Please Select
Boy
Girl
Does not matter
Sponsor Type
*
Please Select
Teacher
Child
Both
Level of Sponsorship
*
Child - For a Month $25
Child - For a Year $150
Teacher - For a Month $120
Teacher - For a Year $1,400
Bundle- $150-Yearly with 1st Month of $100
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