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College Care Packages

College Care Package Order Form

Send a care package to your child on campus - FREE OF CHARGE!

This offer is for Orange County families only

Optional donations and sponsorships are appreciated

Sponsors:
Mitch Wenzel
Maria Rabinowitz
Name of College Student
First Name Last Name
Name of School

Address to mail care package

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Your Name* Person applying for care package (parent, grandparent, friend)
First Name Last Name
Your Phone Number*

Area Code Phone Number
Your E-mail*
Comments:
Optional Sponsorships Help cover the cost of the care packages

$18$36$54$72$118$180$360$540$1000
Total

$0.00
Yes, I'd like to donate the cost of processing this transaction by adding 3%

Donation Method

Credit Card

We accept Visa, MasterCard, American Express, Discover
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

Billing Address

Street Address

City

State / Province

Postal / Zip Code

Country

I would like to receive news and updates by email
Should be Empty:

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