Yes, I want to sponsor Tara(s) for the Temple Fund!

Tara # _________
Name: _____________________

Tara # _________
Name: _____________________

Tara # _________
Name: _____________________

Name: ______________________________________________________

Street: ______________________________________________________

City: ______________________________ State:_________ Zip:________

Email: ____________________________ Phone: _____________________

PAYMENT PLANS

One Year Plan
$83.33/ Month
$500 Bi-Annually

Two Year Plan
 $41.67/Month
$250 Bi-Annually
$500/Year

  

Check enclosed for one-time payment of $__________.
Check enclosed for first of two payments of $500 each.

Please charge my credit card for $________________.
Please set up my credit card payment plan as indicated at left.

Card #: _______________________________ exp:_______

Signature: ________________________________________

  
Mail to: Tara Mandala, PO Box 3040, Pagosa Springs, CO 81147 ...Phone: 970-731-3711...Fax to: 970-731-4441