Extend Your Heart                                                                                              
                                               EIN#: 01-0615288                                                                                              

                                                                                      Donation Form                                                                           

 Please leave this field empty

Please fill out this page and keep a copy for your record. Thank you.


Contact Information
* First Name:
* Last Name:
* Address:
Phone:
* Email:


EXTEND YOUR HEART PROGRAMS DONATION AMOUNTS                    
Education Sponsorship
- $100 can help a student (1st-12th grader) to go to school for a year.
$ for student(s)
1. 2.
3. 4.
Preschools of Love at Nghe An and Vinh Long
- 50 cents can provide a child a meal/day
- $50 supports one month salary of a teacher
$
Bicycles
- $70 can buy a bike for a student to go to school
$
Administrative Fund: any amount is helpful.
- 2% Wiring fee for sending money to Viet Nam
$
Total Donation
$

My gift is In Honor or In Loving Memory of someone
Please check the appropriate box below and enter additional information on the comment box.
My donation is In Honor of someone.
My donation is In Loving Memory of someone.

Comments
( You may enter up to 200 characters. )    characters left

 

Extend Your Heart | 3677 Tully Court, San Jose, CA  95148 | 415-310-9503
extendyourheart@yahoo.com
extendyourheart.org

Copyright © 2001 Extend Your Heart. ALL RIGHTS RESERVED.