FAX  OR MAIL-IN ORDER FORM
PLEASE PRINT

Fax To: (970) 925-1181
OR
Mail To:
The Foundation For Mercy and Sharing
201 N. Mill Street, Suite 201
Aspen, CO 81611-1557

QUESTIONS? Call (887) 434-8454 M-F or email us at contactus@haitichildren.com

Donation type Donation Amount
One-time gift $
Monthly Gift
Satisfy your passion for the mission of Mercy & Sharing and give where the need is greatest. A monthly general funds gift will allow Mercy & Sharing the flexibility needed to respond quickly to crisis, injustice and other threats to the children in our care.
$
Sponsorship Opportunities
Whatever your passion, we have an opportunity for you. Sponsor a disabled child, a healthy child, a student or teacher, and so much more.
Sponsor a Healthy Child     ($50 a month or $600 annually)
Sponsor a Disabled Child     ($100 a month or $1200 annually)
Sponsor a Student     ($25 a month or $300 annually)
Sponsor a Teacher     ($150 a month or $1800 annually)
Sponsor a Shipping Container     ($600 a month or $7200 annually)

Personal Information


 Name:           

Phone:

Address1: 

Email:

Address2:
 

City, State, Zip, Country:
Donation Frequency Information (just for Sponsorship Opportunities) Donation frequency: monthly annualy
Day of a month (for monthly) : 15 25
Payment Methods    Money Order     Check  (include with mail)
 Credit Card (Visa, Master Card, AMEX)

Credit card Number Number:  _________________________   

Expiration Date: ______________________

Signature: ______________________
 Checking Account
Account Type :
Checking; Business Checking; Savings

Bank Name:  _________________________   

Routing Number: ______________________

Account Number: ______________________

Account Holder Name: ______________________

Signature: ______________________

Save time Donate Online www.HaitiChildren.com