Donation Form

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Donation Form

Please read description before submitting. You have to be completely sure first. Thank you.

📣 READ DESCRIPTION FIRST

You have to be sure first before submitting this. Once submitted, you can no longer cancel your donation nor ask for refund. Please read and analyze the rules and terms.

Rules and Terms *

I agree that once submitted, I can no longer cancel my donation.

I understand that refund is not applicable. Therefore, I won't ask for it.

I also understand that I can't spread the number to be given for safety and security.

I accept the rules and terms.

Required

Full name

Type "Anonymous Supporter" if you want to be anonymous or "Skip" if you somehow feel uncomfortable

Contact number

Number you will use to donate *

It can be also the same you provided for contact number. Please make sure that the number given is accurate.

This donation is for: *

Women with breast cancer

Children who suffered violence

Buying meals for hungry families

All of the above. (WILL BE SPLITTED)

Required

Mode of Donation *

Time of submission *

Time

Date of submission *

YYYY

Amount of money you wish to donate *

I understand that after submitting this, I have to DM @survivingstarsc on Instagram/Twitter or email them to confirm my donation. *

Check the second box if you wish to be anonymous

Yes

I am an anonymous sender/supporter

Required

Submit

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