100% Club Registration Form

(* Denotes Required Fields)

Step 1: Your Information
First Name: *
Last Name: *
Company/Organization:
Email Address: *
Primary Phone: *
Street Address: *
City: *
State (e.g. GA): *
Zip Code:
How did you learn about Horizons Atlanta?: *
Step 2: Sponsorship Preferences
Is there a specific scholar you would like to sponsor? If so, provide as much information about that child as possible and Horizons Atlanta will contact you about the match. Please note if you are a renewing member, you will be matched with your scholar from last summer:
If not, please answer the following questions and we will match you with a scholar who fits that description:
In what grade would you like for the scholar to be enrolled?:	K-2 3-5 6-8
Do you have a preference for which program you would like your sponsorship to support?:	Atlanta International School Atlanta Technical College Clark Atlanta University The Galloway School Georgia State University Georgia Tech Holy Innocents' Episcopal School Kennesaw State University Purpose Built Schools Woodward Academy No Preference
Step 3: Donation
Please indicate your method of payment. Online payments will be processed immediately via our DonorBox site: *	Online Check