The young person of today is the elder person of tomorrow. Universal Crosswise of Solidarity it is in favour of the elder people. I authorize to debit from my credit card ....................... No. .....................................Expire ........................... Or, I authorize to debit from my savings account ( ), current account ( ) No. ........................................Bank ............................ The quantity of $ ....... Monthly ( ) - Quarterly ( ) - In Semesters ( ) - Annually ( ) - Unique ( ) I.D. # .......................................... Signature .................................................. First and Last Names ............................................................................................................................. Address ................................................................................................City ................................... Phone number ............................ Fax .............................. Zip code or PO Box: .......................... e-mail ................................... Grants - Banco del Pichincha current account 3006506104. Ecuador. Money order from other countries: - swift code of Banco del Pichincha: PICHECEQ current account No. 3006506104. Account name: FUNDAMAN. Please send this coupon to:br>PO.Box. 17-17-279. Phone and fax: (593-2) 225 6658 / (09) 947 6258 e-mail: fundaman@zona-andina.net Quito - Ecuador