Sponsorship Form

Please copy the following information into a word processing program, fill in the form, print, and send with your check or money order payable to:

Tibetan Refugee Assistance Program

Mail the form or letters of inquiry to:

Tibetan Refugee Assistance Program
c/o Ngawang Jorden
5514 S. Blackstone #329
Chicago, IL 60637

Please print!

SPONSORSHIP FORM

Name:________________________________________________________

Street address:______________________________________________

City, State and Zip/Postal Code:_____________________________

Country:___________________________________

Telephone:___(____)_________________________

Educational Assistance Program:
I wish to sponsor ___ child/children or a young monk/nun by contributing $20 per month per individual. At this time, I intend to commit to at least ___ year(s) of sponsorship. I have enclosed sponsorship dues for the first year of US$___ (plus US$___ donation for administrative expenses), totaling US$___.

Family-in-Need Assistance Program:

I wish to sponsor a Tibetan family by contributing US$___ per month. I understand that I will be matched with a family of the appropriate size ($20 per person per month). I have enclosed sponsorship dues for the first year (plus US$___ for administrative expenses), totaling US$___.

All contributions are tax-deductible. Additional contributions for administrative expenses are also greatly appreciated.