Formulir Donasi
Nama :
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E-mail :
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Nomor telepon :
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Jumlah donasi :
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Warna / jumlah / ukuran t-shirt yang dipesan (apabila donasi > Rp 150.000) :
Contoh : biru/1/l, biru/2/m, merah/1/xl
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Alamat pengiriman t-shirt :
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Keterangan tambahan (bila ada) :
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