" PLEASE RE-VISIT SITE MARCH 20, 2006 FOR COMPLETE INFORMATION ON THE FREEDOM TOUR "

Please print this form and mail in your donation to support our Freedom Tour

S.H.A.P.E. COMMUNITY CENTER
19th Annual Freedom Tour 
July 21, 2006 - July 28, 2006

Scholarship Contribution Form

PLEASE TYPE OR PRINT

   NAME ___________________________________________________________________

   COMPANY _______________________________________________________________ 

    ADDRESS  _______________________________________________________________

    TELEPHONE _____________________________________________________________

PLACE A CHECK MARK IN THE BOX NEXT TO ALL THAT APPLY: $600 will provide a complete scholarship for a youth to participate in the 19th Annual Freedom Tour (includes hotel, transportation, meals, and tours.)

SCHOLARSHIPS        # OF SCHOLARSHIPS            TOTAL AMOUNT 

   $600                       ________________                 _____________

   $400                       ________________                 _____________

   $300                       ________________                 _____________

   $100                       ________________                 _____________

   $ ____________________________                     _____________

  I would like for this donation to be applied to: Students Name ____________________________________________________________

Mail Check or Money Order and Completed form to: 0 S.H.A.P.E. Community Center- Freedom Tour - P.O. Box 8428 - Houston, TX 77288-8428

"In The Spirit Of Unity"

"THANK YOU FOR YOUR DONATION AND CONTINUED SUPPORT"