:: Humanitarian Mission in Guyana ::

We deeply appreciate and value all your past, present and future contributions and please be assured that all your contributions have been and will be utilized in full to benefit the lives of the less fortunate. No contribution is ever too small or too big. All contributions are tax deductible.

Pledge to New Jersey Arya Samaj Humanitarian  Donors:

100% of donations will go directly to meeting the needs of the less fortunate children and seniors in Guyana. None of the donation will be used for administrative costs.

This work is too big for us alone…we need your help!

Yes, I’d like to partner with the New Jersey Arya Samaj Humanitarian Mission for the underprivileged to help… “Bring Purpose and Joy to the less fortunate children,seniors battered women and others in need in Guyana”!

With my monthly donation of: $5 ______ $10 _____ $20 ____ $50 ___ $100 ___$250 $_____ (Other)

Automated Donation Debit Authorization

I have enclosed a check for my first month’s gift. Please transfer my monthly gifts from my bank
account. I understand that my future monthly gifts will be transferred directly from my banking
account on the 30th of each month, and will appear on my bank statement. If at anytime, I wish to increase, decrease, or suspend my giving, I can notify the New Jersey Arya Samaj Humanitarian Mission  of my desires with a written request.

Name:__________________________________________________________________________

Address:_________________________________ City:______________________ State: ______

Phone:_________________________________ Email:__________________________________

Donor Signature:____________________________________ Date: _______________________

How would you like your donation to be used:

(please mark one)

o Any New Jersey Arya Samaj Humanitarian Mission Initiative
o Less fortunate children and  orphan Care
o Low working income families and single mothers
o Medical care (such as surgery outside of Guyana)
o Food Vouchers for seniors, battered women and underprivileged children
o Education fund fro children living in dire poverty
Benevolent home for seniors / Battered women and orphans

Send this form, with your first monthly check to:

NJ Arya Samaj Humanitarian Mission
PO Box 5119
191-913 Woodlawn Avenue
Jersey City, NJ 07305

For further information please feel free to contact us.