BUYAMBA CHILD SPONSORSHIP / DONATION FORM Name of Donor/Sponsor * Address * City * State * Zip Code * Phone Number * Cell Phone number Email Church or Group? Interested in Child Sponsorship (Name of child if known) Other Donation Love Gift Donation Choice     Payment Method Cash Check Credit Card New Sponsor Current Sponsor     Check for one-time only credit card transaction: Amount to charge: $     Comments or instructions:     CHECK FOR RECURRING CREDIT CARD TRANSACTIONS Frequency: Monthly ($35) Quarterly ($70) Semi-Annual ($210) Annual ($420)     Monthly recurring credit card transactions will occur on the 1st day of each month unless otherwise noted. Credit Card Type: Select Visa Mastercard Discover Name on Credit Card: Address on Credit Card Account: Credit Card Number: Expiration Date: 3-digit Security Code on back of card:     SIGNATURE OF CARDHOLDER:

Make all checks payable to:

Buyamba Uganda
3625 East Thousand Oaks Blvd, #265
Thousand Oaks, CA 91362

If you have any questions please contact:

Julie Dimas at julie@ugandabuyamba.com
or (805)558-0089

To contact the school directly:

Pastor Bethuel and Florence Dongo
P.O Box 26977 Kampala Uganda
EastAfrica.
Tel:  265 75 212404/265 75 599862
Email: pastordongo@ugandabuyamba.com