Donation Form

姓名 Name *	:
性别 Gender *	:	男 Male女 Female
职业 Occupation *	:
联络 Contact *	:
电邮 Email *	:
地址 Address *	:
公司名称 Company Name	:
公司地址 Company Address	:
捐款数额 Donation Amount *	:	RM
捐款方式 Payment Type *	:	-- Please Select Payment Type --现金 Cash网上银行转账 Online Bank Transfer支票 Cheque提款机转账 ATM Transfer
验证码 Verification	:

For Donation, please made payable to:

Account Name:
“BEAUTIFUL GATE FOUNDATION FOR THE DISABLED”

Public Bank Account No: 3191107324

Please fax or email your bank in slip with fill in details in the attached form.

Email: puchong@beautifulgate.org.my
Fax: 603-80520642

Your donation to us are Tax Exempted.

有意捐款，请填上美门残障关怀基金会蒲种中心银行户口资料

敬请填妥附上个人资料表格，连同银行存款收据传真或电邮给我们。

（您的捐款可获得扣税。）