Vietnam Detox Project Donation Form

Our Vietnam humanitarian project has surpassed the 10,000 program participants served! A new milestone.

The demand is great!

Our next goal: Fund 1,000 participants at $500.00 per person to cover vitamin costs, general project support, the monitoring of participant outcomes and the compilation and publishing of results.

Fund Raising Goal For This Campaign: $500,000

Contributor Recognitions & Participation
Vietnam Detox Project Visionary Patron – $100,000
Vietnam Detox Project Milestone Maestro – $50,000
Vietnam Detox Project Humanitarian Hero – $10,000
Vietnam Detox Project Champion - $5,000
Vietnam Detox Project Advocate – $1,000
Vietnam Detox Project Supporter – $500

Contact name:

Phone:

Area CodePhone Number

Contact Email:

Donation Payment Options

Vietnam Detox Project Visionary Patron$100,000.00

Help 200 participants

Vietnam Detox Project Milestone Maestro$50,000.00

Help 100 participants

Vietnam Detox Project Humanitarian Hero $10,000.00

Help 20 participants

Vietnam Detox Project Champion$5,000.00

Help 10 participants

Vietnam Detox Project Advocate$1,000.00

Help 2 participants

Vietnam Detox Project Supporter$500.00

Help 1 participants

Total $0.00

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

By clicking the submit button I fully authorize my card to be charged by FASE, the Foundation for Advancements in Science and Education and it's initiatives, FASE Productions/the Futures Channel/Green Technology in the support of the Vietnam Detox Project and it's participants.