Children Up Donation Form

Thank you for your interest in ChildrenUP

You may elect to receive information via email and/or postal mail

Name
Email Address
Home Phone
Mobel Phone
Home address
Check here to receive information via email
Donation Information
Select your donation choice from the following list.
You may use the PayPal or mail your check to:		ChildrenUP 481 W. Alma Street Elmhurst, IL 60126-3103
a gift of $4,000 - supporting one student for four years
a gift of $1,000 - supporting one student for one year
a gift of $500 - supporting tuition for one year
a gift of $80 - school supplies for one term
a gift of $15 - for a ChildrenUP Tee-shirt		Small Medium Large Extra Large XX Large
Other - an amount of your choice

Yes, I would like to have my name on the ChildrenUP donor page
Please list my name in the following manner:
Examples: Mr and Mrs. John Smith In Memory of Jill Smith In Honor of Mary Hill The Jone's Fund Anonymous
Form of Payment:	Paypal
	Check


Click here to continue to pay with PayPal