Response Page
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This site is dedicated to helping MIBOSAM bring hope, help, and healing to Haiti.

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            MIBOSAM Response Form

Please use this form to tell us something about yourself and/or your organization. If you would like to make a donation immediately click here    

Please provide the following contact information:
Name
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
E-mail
URL
Select any of the following options that apply:

I would like to sponsor a student for a one time gift of $125.
I would like to sponsor one weekly broadcast for $150.
I would like to get my church or group to sponsor a MIBOSAM ministry.
I would like to invite a MIBOSAM representative to speak to my group.
I would like to join or organize a work group to Haiti.

Include any message:


Stephen Schwander
Copyright © 2005 MIBOSAM. All rights reserved.
Revised: August 29, 2005