Extend Your Heart                                                                                              
                                               EIN#: 01-0615288                                                                                              

                                                                                      Donation Form                                                                           

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Contact Information
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* Last Name:
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Phone:
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EXTEND YOUR HEART PROGRAMS DONATION AMOUNTS                    
Education Sponsorship
- $150 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, Vinh Long and Kien Giang
- Any amount will help providing classroom materials/supplies and nutritious meals for kindergarteners.
$
Bicycles
- $100 can buy a bike for a student to go to school
$
Administrative Fund: any amount is helpful.
- 4% 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.

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