Back to School Donation Form

"Back To School" 2011

Please fill in the pledge form below before donating to our Back to School 2011 campaign. Sila isi borang berikut untuk menyertai kempen Back To School 2011.

1 Nyatakan Penama

2 Info Waris/Wakil

3 Cara Pembayaran

Full Set
Price: RM 250.00 Quantity:
Please state the quanity of sets that you would like to donate. (Sila nyatakan kuantiti untuk diderma.)
Additional Donation Amount (RM)
Total
RM 0.00

Nama*
PrefixFirstLastSuffix
Email*
Address*
Street AddressCityZip / Postal CodeCountry
Phone*

Total
RM 0.00
Cara Pembayaran*
- CIMB Clicks (online)
- Maybank2u (online)
- iPay88 (Visa, MAsterCard, Alliance, AM Assurance, RHB, PBE, HongLeong, BankIslam, MobileMoney, PosPay)
- CIMB Bank In (cash)
- Maybank Bank in (cash)
- Other
Other Payment Method
Please state your method of payment if it is not listed above. Sila nyatakan cara pembayaran yang lain.
Receipt to be issued*
- Individually (to address provided)
- No receipt required
Sila nyatakan sama ada resit perlu dikeluarkan atau tidak.
Remarks
If you want to notify us concerning anything related to this donation, please specify it here clearly.

Jika anda ingin memberitahu kami mengenai apa-apa jua yang berkaitan dengan derma ini, sila nyatakan ia di sini dengan jelas.

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Charity Shoppe Operation Hours

Tuesday - Saturday : 11am - 7pm
Sunday : 11am - 3pm
We are closed on Monday

Volunteer Induction Course

Date: May 19 , 2012
Disclaimer

Setiap sumbangan yang tujuannya tidak dinyatakan secara spesifik, secara automatik akan disalurkan ke Dana Umum Islamic Relief Malaysia.

Unless we are notified on the purpose of the donations, all unidentified donation shall be channeled to General Fund.
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Back to School Donation Form

"Back To School" 2011

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Disclaimer

How to Help

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ISLAMIC RELIEF MALAYSIA

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