East Meets West Foundation - The Foundation for Learning, Healing and Health in Vietnam

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Fax/Mail Donate Form

To donate by fax or mail, please fill out this form below out and mail or fax it to the East Meets West Foundation with your credit card information filled out or include a check for your donation (make checks payable to East Meets West Foundation).

I want to make a one-time donation. I want to make a recurring donation. Please charge my credit card or send me an invoice (choose one): Every month Every 3 months Once a year
DONOR INFORMATION
First Name:
Last Name:
Address:
City:
State:
Zip Code:
Country:	U.S.A Other, Please specify:
E-mail:
Anonymous Donation Information I prefer to make this donation anonymously.
PAYMENT INFORMATION
I have enclosed a check made payable to the East Meets West Foundation.
I prefer to pay by credit card.
Credit card Type:	MasterCard Visa
Credit Card Number:
Credit Card Expiration Date:
DONATION INFORMATION
I want my donation to support the following program: ADAPT {anti-trafficking program} Breath of Life (neonatal health program} Clean Water and Sanitation Program Dental Program Early Childhood Education Centers Operation Healthy Heart School Construction SPELL scholarship program Support Network for People with Disabilities Village of Hope General donation (to be used where it is needed most)
GIFT RECIPIENT I'd like to make this donation (choose one below) on behalf of in memory of as a Vietnam Compassion Gift* Please send acknowledgement of this gift to: (Enter recipient's full name, email address or mailing address so EMW can send a gift card or letter acknowledging your donation.) GIFT CARD (choose one below) I want a gift card mailed to my gift recipient. I want a gift card mailed directly to me. Please include this personal message on the gift card (25-word max)

Please print and mail or fax this completed form to:

East Meets West Foundation
P.O. Box 29292
Oakland, CA 94604
Fax: 510-763-6545

If you have any questions. please call us at 1-800-561-3378.

Thank you for your generous support of the East Meets West Foundation.

Find out more about our Vietnam Compassion Gift programs at http://www.eastmeetswest.org/getinvolved/compassiongifts.html.