Bina Roy Partners in Development - BRPID

General Donation Form

Fields marked * are required.

FULL NAME* of national federation / association / branch / individual wishing to make a donation :

CONTACT DETAILS*:

Street
City Postal Code
Country
E-mail


AMOUNT OF CONTRIBUTION* (please state currency):

EXPECTED DATE OF DONATION*:

COMMENTS:

METHOD OF PAYMENT *:

Bank transfer to IFUW (account details will be provided after you submit this form)
Paypal (Paypal payment link will be provided after you submit this form)
Check for donors in Canada and the USA only (address to be provided after you submit this form)
Gift Certificate (Please enter your Gift Certificate Number in the Comments box above.)

Signed*:

Date*:

 

If you have problems sending the form, you may either email us on print a copy and fax it to IFUW Headquarters - Fax: (+41 22) 738 04 40.