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Yes, I/We would like to join CHIA in the "Living Water Project"
Any investment in any amount is important. Although we run with a very lean staff, your sponsorship of this project will go a long way in helping provide clean drinking water to a village and/or family in Mexico. We welcome your monthly or one time investment of any amount.
           Your Information
Prefix: 
Name/Company: 
Contact: 
Address: 
City, State: 
Zip: 
Telephone: 
E-Mail: 
 
           Sponsorship
 
Full Drip System (1 year) $ 375.00 (includes replacements)
Full Drip System (startup) $ 275.00 (setup for 6 months)
Full Home System (1 year) $ 60.00 (includes replacement)
Full Home System (startup) $ 40.00 (setup for 6 months)
other special donation for the project
           Credit Card Information
Card Type: 
Card Number: 
Card Owned by: 
Personal Business Church
Expiration Date: 
/
Amount($): 
Based on sponsorship or special donation
  Please enter the billing address if it is different from above
Billing Address: 
Billing City, State: 
Billing Zip: 
Billing Country: 
   
           Donation Information
 
I want to partner with CHIA Missions.
I'd like to give this one time.
I'd like to give this amount on a monthly basis by this credit card.
I'd like to give this amount on a monthly basis by check.
   
           Comments
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