I want to sponsor a child's education for US$7 a month, for 12 months:

My name:Name

Address:Address

City, State, Zip:Address

Phone:Phone

E-mail:Address

I/We would like to sponsor (number)          children.

I would like to sponsor a
(circle one) girl / boy / doesn't matter

I would prefer a younger child.
(circle one) yes / no / any age


We will attempt to accommodate your wishes, however, remember that the children are selected on the basis of need. Within a few weeks you will receive a card from the child you are sponsoring, along with a photo.

MAILING INSTRUCTIONS:
Print this form (use the "File-Print" feature at the top of this browser window). Then complete the information on this form, and send it with a check for US$7 for the first month's sponsorship, or — for Canadians — send a bank money order in U.S. dollars, check/money order payable to:

UPPER ROOM MINISTRIES
Attention: Mory Student Sponsorship Program
5081 Roxborough Drive
Placentia, CA, US 92870

Thank you for your generosity!

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