SPONSOR A CHILD.

Please complete the following form so that we can apply your generosity to the activity provider that you have chosen.

SHEPARD PROVIDER INFORMATION

What activity would you like to sponsor a child to?

What is the business or organization name that provides the activity?

Do you know the estimated annual or seasonal cost including equipment for this activity? Yes No

If Yes, enter the amount in this field.

How much would like to give towards an annual sponsorship?

$ Donation Amount:

Personal Info

First Name *

Last Name

Email Address *

Credit Card Info

This is a secure SSL encrypted payment.

Card Number *

CVC *

Cardholder Name *

Expiration *

Donation Total: $100.00

YOUR INFORMATION

Best time to reach you - From

From

SHEPARD PROVIDER INFORMATION

% Annoual cost you want to pay

What activity would you like to provide a sponsorship to?

What is the business or organization name?

Do you know the estimated annual or seasonal cost including equipment for this activity? Y/N --- If Y, enter the amount in this field.

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