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SPANDANA Credit Card Payment Form |
Credit
Card Payment Form for VISA and MASTER card |
Please
fill in the form and print it before mailing to the
given address
below |
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Name |
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Address |
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City |
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State |
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Zip/Pin
Code |
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Phone |
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E
mail |
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| Yes!
I would like to donate towards SPANDANA an amount of |
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Rs |
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Credit
Card Type |
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Date
of Expiry |
DD
M
Y
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Credit
Card No |
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Date of birth |
DD
M
Y
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Place |
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Date |
DD
M
Y
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Please
credit the said amount to " SPANDANA" |
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| Signature:
_____________________________ |
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| Please
mail the form to the address below: |
……………cut here to use below
text as address label…………… |
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SPANDANA
2-1-88/B/8/1,
Krushi Nagar colony,
Bandlaguda, (Nagole),
Hyderabad - 500068
Andhra Pradesh, India.
Phone : +91-40-32998863
Email : info@spandanaindia.org
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