Student Sponsorship $ Donation Amount: Male Student, MonthlyFemale Student, MonthlyMom +1 Child, MonthlyMom +2 Children, MonthlyMom +3 Children, MonthlyCustom Amount Make this donation every dayweekmonthquarteryear Date * Required Who is filling out this form? * Required - select who is filling out form - Staff / Intern Self Sponsor Name * Required Sponsor's Phone Number * Required Center Location * Required - select center location - Shreveport Minden Ruston Dodson Winnfield The Bridge Lafayette New Orleans Corporate Do you already have a student name you would like to sponsor? * Required Do you already have a student name you would like to sponsor? * Required Yes No If you answered "Yes" above, please give us their name. * Required Would you like us to assign a student to you today? * Required Would you like us to assign a student to you today? * Required Yes No Have you already received a packet? * Required Have you already received a packet? * Required Yes No Please let us know what event you attended if applicable. 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