WAO: Donor's Form

Donor's Form

First Name:

Last Name:

IC Number:

*applicable to Malaysians only

Email Address:

Telephone:

Address:

City:

State:

Country:

Commitment:
(please select)

For one-time donation, please enter amount

RM

For pledge, please enter amount and pledge period

Pledge amount RM

Pledge period years ( From year to year )

Mode of Payment:
(Please select)

I will bank in the above amount to WAO’s Public Bank Account

I will send a cheque payable to Women’s Aid Organisation to

Women's Aid Organisation (WAO)

P.O. Box 493, Jalan Sultan

46760 Petaling Jaya

Selangor

Malaysia.