Child Sponsorship Shopping Cart

Child Information

*Reference Number:

*Name of Child:

*Village/House

*Date of Birth:

E-Mail

Important: Enter a valid e-mail address. Receipts will be sent to this address.

*E-Mail:

Billing Information

*First Name:

Same name as on your card

Middle Initial:

*Last Name:

*Address Line 1:

Where your statement is mailed

Address Line 2:

Apt. or Suite No.

*City:

*State:

*Zip Code:

*Phone:

Sponsorship Information

Sponsor a Child:

Monthly

Add to Cart

Sponsor a Child:

Annually

Add to Cart

Credit/Debit Card Information

*Card Number:

No dashes or spaces please

*Expiration Month:

From your card

*Expiration Year:

From your card

*Card Brand:

Save Form Reset Submit