Sponsorship Application

I(We) would like to take part in the sponsorship program to provide assistance for a child under the care of Eastern Social Welfare Society, Seoul, Korea.
Full name:
E-mail address:
Telephone number:
Full address:
Distribute my payments to:	A. Babies in need of special care B. Orphans under the age of 3 C. Orphans with impairments D. Korean students E. Pregnant single mothers F. Other services
Payment schedule:	Monthly ($25.00) Quarterly ($75.00) Semi-Annually ($150.00) Annually ($300.00)
	e-mail: info@dillonsouthwest.org Phone: 480-945-2221 Fax: 480-945-3956