The Teacher-to-Teacher Program

Please consider donating part of these teacher’s salaries.  Their salary is $20 month.  They were not paid this year until O.M.O.S. provided funds for their meager salary.

Name:

School:

Street Address:        
2nd line (if needed): 

City:   State:    Zip:

E-mail address:

I'm interested in the program, but want to learn more before I commit. 
        Please contact me by email at the address I've given above.

I'm interested in the program, but want to learn more before I commit. 
        Please contact me by phone at:  Area code: Phone #

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Donation amount: Please check one

  Full Salary:    $20 per month for 6 months in 2003-04
                           (August, September, October, November, December, January)

  Half Salary:     $10 per month for 6 months in 2003-04
                          (August, September, October, November, December, January)

Quarter Salary:  $5 per month for 6 months in 2003-04
                            (August, September, October, November, December, January)  

Other:   (please enter below)

ADDITIONAL COMMENTS OR QUESTIONS:  (please include any additional comments or questions you might have here:

After you submit the form, someone from the Haiti Project Committee
will contact you within a few days to follow-up.

    THANK YOU & BLESS YOU!