Sponsorship Application Form

Full Name (of Sponsor):

Telephone #:

Mailing Address:

Sponsorship Duration: year(s) or from to

Email Address:

Level of Sponsorship (tuition only, books and board, other fees, food):

Financial Amount (How much are you willing to give to the student?):

Specifications and requests:


In place of your signature, please type your full name in the space provided to verify that all information given is correct, and you agree to receive further information about the Lazarus Foundation A-P/Quang Tri EAPA Sponsorship Program.