Floral Image - Dallas Credit Card Form

Sponsorship Program (Please Select)*

Full Sponsorship for Tuition & Board

$110 per month covers accommodation, education, educational and school resources, school uniform, daily meals and annual medical check-up.

$110.00AUD Quantity

Half Sponsorships for Tuition & Board:

$55 shares the full sponsorship cost with a second sponsor.

$55.00AUD Quantity

Total

$0.00AUD

Student Sponsorship Form

Please complete this form in order to make payment via credit card
Name
Full Name
E-mail
example@example.com
Billing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
By signing below I hereby authorise Katoke Trust for Overseas Aid to charge my credit card for the amount shown above on a month to month basis.
Authorisation Signature

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Student Sponsorship Form