Donation Form
Enclosed is my donation/gift of amount: $______________
Name: _____________________________________________________
Address: ____________________________________________________
City/State/Zip: _______________________________________________
Telephone: __________________________________________________
Email: _____________________________________________________
The project I have choose to fund is #:_____________________
Project Name: ________________________________
We value your privacy as dearly as our own. We will not share any of your personal information with ANY third party. If you agree for The Phamile Foundation, to publish your name, picture and testimonial on our website, your other personal information will be kept completely private.
I agree for The Phamile Foundation, to publish on their website:
My name: ______YES _____NO
My motivation testimonial ______YES _____NO
To publish my picture (we will contact you by email): ______YES _____NO
Please write your motivation (testimonial) as why you made a donation/gift below:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Signature: ______________________________________ Date: ______________________
Your contribution is fully fax-deductible.
Thank you very much
The Phamile Foundation
13 Siri Lane Scotts Valley CA 95066 USA
Telephone: 415-812-5683 Website: www.Phamile.org E-mail: phamilefoundation@gmail.com