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With your donation you will bring an effective and powerful symbol of love and hope into this world. You'll help to alleviate human misery in the mountain valleys of Peru.

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I want to take a monthly sponsorship of a child.
$35*   $70*   $85*
$140*
$210* (full sponsorship)
I want to take a monthly sponsorship of a student.
$50*
I want to take a monthly sponsorship of a teacher.
$140*
I want to support the various projects of "Corazones para Peru"
with an amount of $.
one time only   monthly*   quarterly*   yearly*
I like to donate warm meals to the schoolchildren.
$20*   $40*   $85
I want to receive more information about the project.
     * recurrent donations can be terminated at any time.

Title: 
 *
Company: 

Profession: 

First Name: 
 *
Last Name: 
 *
Address: 
 *
ZIP-Code: 
 *
City: 
 *
Phone: 
 -  *
Fax: 
 - 
E-Mail-Adress: 
 *

                              * Fields marked with a red asterisk have to be filled out.
Account Owner: 
 *
 
either Name of Bank / Account No / Bank Code No
Name of the Bank: 
 *
Account Number: 
 *
Bank Code Number: 
 *
 
or IBAN / BIC
IBAN: 
 *
BIC: 
 *
 I hereby agree to the processing of my data. *


Security number:
 12635


 



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