divyadeepatrust.org - Donor Form

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Donor Form

Name *		This contains the donor name
Refered By		This contains the name of the referred person
Address
Phone *		You can provide your contact numbers here. Mobile / Landline etc.. Please include STD code as well if in case you are providing land line numbers.
Email *		eg: admin@divyadeepa.com
Special day in a year		Like your Birthday, Anniversary on which you receive a greeting card from us
Schemes	Donate Any Amount (Mention specific purpose if any or will be utilized as per the need of institution.Use the "Scheme Details" field ).
	Pragati (Towards supporting a single child - Rs.1000/- per month or Rs.12000/- per year or once towards corpus fund Rs.120000/- And mention the child name in the scheme details text area below)
	Sattwa (Towards food expenses on a particular day of your choice. Rs.1000/- per month or Rs.12000/- towards corpus fund.Mention a particular day and an occassion in the scheme details text area below)
	Vidya (Towards school running expenses. Rs.500/- per month or Rs.6000/- per year or Rs.60000/- towards corpus fund)
	Dhanwantri (Towards health care expenses of children. Rs.250/- per month or Rs.3000/- per year or any amount towards corpus fund)
	Chaitanya (Donation in Kind.Contact us for wish list )
Scheme Details		Eg : Refer your selected schemes above.