If you would like to sponsor a Haitian child, simply print out this form, along with at least the first month’s support of $25.00 (checks payable to Partners with Haiti) and mail it to:

Partners with Haiti 25 Old County Road Barrington, RI 02806

You will receive a picture and information about your child. We are confident God will bless you as you share what has been entrusted to you. If you have any questions, please contact Rachel Pitot, Bethany Project Coordinator (U.S.), at rachel@partnerswithhaiti.org.

Please check each box below for your preferences and fill in each line:
    Boy (age 5-10)     Boy (age 11-18)     Girl (age 5-10)     Girl (age 11-18) 

Either a Boy or Girl, any age (does not matter)

Specific School Interest ________________________________________
Enclosed is my first payment of _________________________________
I would like the following sponsor payment options:             $25 One Month           $75 Three Months 

$150 Six Months       $300    One    Y ear

Name ______________________________________________________

Address ____________________________________________________

City _______________________________________________________

State ___________________________ Zip _______________________

Phone Number _______________________________________________

Email ______________________________________________________