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Chances4Cambodia |
Sponsorship Form
Top of Form
We/ I would like to sponsor student(s) for the full 4 year course @ US$4,000 per student
General Sponsorship. The C4C Foundation will select a student(s) from a pool of successful scholarship applicants. If more than three, please attach additional names.
Student 1
Student 2
Student 3
Name of Sponsorship:
Special Faculty Sponsorship is for sponsoring students who wish to study in the following faculty:
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Agriculture. Land Management Commerce Engineering Nursing |
Banking & Finance Education Information Technology Law |
Name of Sponsorship:
Special Student Sponsorship please choose your student(s) from the general pool of successful scholarship applicants.
Name the scholarship as:
Other donations:
I would like to donate to the General Support Fund an amount of: $
Paid by:Paypal__________Cash__________Check No. Dated:
Total Amount Pledged: $
Donor Special Request:
Payments can be paid directly
to our Cambodian Branch:
Name of Account: CHANCES4CAMBODIA
Name of Bank: ANZ-Royal
Account Number: 1684240
Account Type: Business/ Check Account- Currency US$
Alternately Payments can be paid to our
Headquarters in the Netherlands:
Name of Account: Chances4All
Name of Bank RABOBANK
Account Number: 1394.32.868
IBAN: NL61 RABO 01394.32.868
Or directly through our PayPal
facility on our Websites C4A & C4C:
All contributions are fully tax deductible
Receipts provided for all donors
Certificates awarded to donors over US$100
Name of Sponsorship/Sponsor:
Address:
Phone:
E-mail:
Signature:
Date:
The C4A & C4C Foundation will treat all personal information as strictly confidential and will not disclose the data without the donor’s consent. The C4A & C4C Foundation is an International and local (Cambodia registered NGO). Donations are tax-deductible to the fullest extent of the law. A financial statement is available online on our website www.chances4cambodia.org
Thank you for your kind donation
