To sponsor one or more children in Haiti through FOCAS

please take 5 minutes to fill out the following information

below, and check the ensuing boxes to let us know how

we can best accommodate your interests in this process.

(FOCAS WILL NOT PROVIDE YOUR INFORMATION OR

ITS DATABASE TO ANYONE UNLESS REQUIRED TO DO

SO BY LAW.)

Name
Address
City
State
Zip Code
E-mail
Home Phone (A/C)
Work Phone (A/C)
Cell Phone (A/C)

Please check the following boxes as they apply to you:

Sign up to Sponsor One or More Children in

Haiti for $20 per month (If more than one, please explain in Comments Box below)

I would like to Sponsor a Boy

I would like to Sponsor a Girl

I would like to be billed $20/child each month.

I would like to have the $20/child automatically billed to my Credit Card. (We will contact you for this information.)

I would like to have $20/child (automatically deducted from my bank. (We will contact you to set this up.)

I would like to host a Chld Sponsorship Meeting at my church or home to recruit other child sponsors. Please send me an information kit and Child Sponsorship DVD to the address listed above.

I am interested in a Mission Trip to Haiti.

PLEASE Share with us how you heard about FOCAS's Child Sponsorship Proram AND/OR Provide us with your Questions, Comments or Prayer Requests. Thanks!

THANK YOU for making a difference, one life at time, in

the life of one child. Please click on the SUBMIT button

below after you have rechecked the information you have

filled out above. If you do not hear from a FOCAS

representative in 3 days please call (513) 621- 5300.