Dutch Sponsorship Application

Yes, I want to be a sponsor.

Step One: Choose Your Sponsorship (info: www.safepassage.org)

  I prefer to be a ongoing child sponsor for a minimum of 1 year.
        I want to be a Child Sponsor ($50 per month).
        I want to be sole sponsor of a child ($200 per month).

  I prefer to be a ongoing Safe Passage Partner.
      Contributions help pay for food, medical expenses,clothing and more.

  I prefer to be a ongoing Classroom Partner ($100 US per month or more).

  I wish to contribute Euro  each month.

  Iīm going to pay through the Dutch foundation "Vrienden van
      Camino Seguro". I will pay my dontation in Euros on the
      Dutch banc account: Rabobank Amsterdam no. 3447.42.318.
      (Please include your name and email address)

  I'm going to pay with credit card.

  I canīt use the previous payment methods, please contact me!

  I would like to pay every: month 3 months  6 months year

Step Two: Personal Information 

  Family Name:     

  Given Name:         MaleFemale

  Street Address:  


  Postal Code:      

  Province or Prefecture:  



Step Three: Additional Information 

  If you wish, please include telephone number and/or your date of birth:

  Phone:   (Include your country and area code, without "-")

  Date of birth:   yyyy    mm    dd

  I have heard about the project from:  

  If you have a question:

Step Four: Send it