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Lama Osel's Education Fund
Pledge Form
Name : ______________________________________________________
Address : _____________________________________________________
______________________________________________________________
Postal Code : ____________________
City : _______________________
District/State : ___________________
Country : _____________________
Please circle the options chosen :
- I would like to help financially support Lama Osel and would like to make a regular contribution :
- monthly
- quarterly
- yearly
- once
for the amount stated below :
- 20 $
- 25 $
- 30 $
- 40 $
- 50 $
- 100 $
- ______________________________ (please specify a different amount or a different currency)
Please charge my : - Bankcard - Visacard - Mastercard (please circle one)
Card number : _______________________________________________
Expiry date : ________________________________________________
Signature : ________________________________________________
Please return this form to :
Lama Osel Support Fund
C/o IOF FPMT
P.O. Box 1778
Soquel, CA 95073, USA
write to me