Villa Esfuerzo  Registration Form

Important Information:  This registration form is only for people that are currently sponsoring a child(ren) at Villa Esfuerzo (Eastern School) in Santo Domingo and wish to transfer their sponsorship and child to Solid Rock Missions.  If you wish to select and sponsor a new child, please click here.

We would like to welcome you to our sponsorship program.  We appreciate the commitment you have made by sponsoring a child at the Eastern School (Colegio Oriental) on Villa Esferzo in Santo Domingo and your willingness to transfer your sponsorship to our program.  The program for this school is the same program we have for all of the schools we that we to work with.

Transitions can be a little tough but we will do everything we can to make the transition for both you and your child as smooth as we possibility can.  If, for any reason, you ever have any questions, please feel free to call us toll free at 888-765-4376 or e-mail us at srm@solidrockmissions.org .

Please fill out this form so we can proceed with transferring your sponsorship to us. We will communicate the changeover of your sponsorship to the other sponsorship organization.  If you have paid the previous organization with an automatic withdrawal program (ACH withdrawal or by recurring credit card payments), you need to contact the other program or your bank to cancel your payments to them. 

 

  

 

Name:

Mailing address

City      State      Zip 

Daytime Phone Number 

Home Phone Number

Email address 

I am currently sponsoring  1    2   3   4 student(s) at the Eastern School on Villa Estuerzo in Santo Domingo.

Information on the students you currently sponsor
Please type in the box the full name(s) and student number(s) (if you have a number) of the child you are currently sponsoring with the other program. 

 
 

Payment Choices
By Check
By Credit Card
Auto Withdrawal Program from your checking account

Frequency (Please skip this if you are paying by credit card).
 Monthly - $26.00 USD
Quarterly - $78.00 USD
Semi-Annually - $156.00 USD
Annually - $312.00 USD

Invoicing (Please skip this step if you are paying by credit card).
If you pay by check, we will send you an invoice before your payment is due.  I would like this invoice sent to:
My e-mail address
To my regular mailing address

Auto Withdrawal Authorization (Please skip this step if you are paying by credit card).
If you would like to allow your payments to be taken out of your checking account, please fill out the following:
 My willingness to provide you my account numbers indicates that I am authorizing Solid Rock Missions to make auto withdrawals to cover my payment to the sponsorship program.
I agree.  Please call Solid Rock Missions at 419-456-9077 or 888-765-4376 to give use your bank routing and account information.


 

Signed (type your name) 

Date  

  		 

Solid Rock Missions
 P.O. Box 334
Wauseon, OH  43567
Phone: 419-956-4077
E-mail: srm@solidrockmissions.org