School Construction     Program Form

I, ________________________________________________, would like to become a member of the School Construction Program (SCP) by help contributing to the construction of a school in Haiti. With my monthly donation of: (please check one)

I will be providing a place where children can learn and get an education. As a member, I will receive photos of the school during the construction. Name_____________________________________________________ Address___________________________________________________ City, State, Zip______________________________________________ Phone (optional)____________________________________________ Email (optional)_____________________________________________ Please make your checks payable to Hope For Haiti's Children Inc. Please print out this form and send it with your check to:                                       Hope For Haiti's Children Inc.                                 c/o Cynthia Khawly                                      16477 SW 100th Terrace                                    Miami, FL 33196    Thank you! By being a member of SCP, you'll be on our mailing list!

$10

$5

$15

$20

$25

Other $_______