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Happy Heart Foundation: Donation Form
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Donation Form
Donor Info
Your Donation
Donation Payment
Your Name :
Title Name
Mr.
Mrs.
Ms.
*
Address :
Birthday :
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Telephone :
Fax :
Mobile Phone :
E-mail :
*
I would like to make a single donation for,
The amount of
THB
I would like to donate for,(Indicate the amount of donation)
(Please indicate)
1 child
2 children
3 children
or
children
500 THB
Monthly
1,500 THB
Every 3 months
3,500 THB
Every 6 months
6,500 THB
Yearly
Total
THB
I would like to contribute towards education; (Indicate the amount of donation)
(Please indicate)
1 child
2 children
3 children
or
children
2,500 THB
Yearly
3,500 THB
Yearly
Total
THB
I would like to donate for "food expenses" (Indicate the amount of donation)
500 THB
Per month
1,500 THB
Every 3 months
3,500 THB
Every 6 months
6,500 THB
Every year
Total
THB
TOTAL SUM:
THB
***Monthly donation can be cancelled by request anytime.***
Donation Details
Donation via bank or via ATM machines to "Happy Heart Foundation" account at your convenience.
TOTAL DONATION:
Cheque or cashier cheque should be crossed with A/C Payee Only and payable to "Happy Heart Foundation"
Bank
Cheque No.
Dated
TOTAL DONATION:
Paypal
TOTAL DONATION:
A receipt can be requested at 095-901-9555 .
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