INDONESIAN UKHUWAH CENTRE
PLEDGE FORM
بِسْمِ اللَّهِ الرَّحْمَنِ الرَّحِيم
Saya ingin memberikan donasi untuk Indonesian Ukhuwah Centre (IUC) seperti rincian di bawah ini:
I would like to make donation to Indonesian Ukhuwah Centre (IUC) as details below:
Jumlah / Amount *
Periode / Recurrence : *
Tanggal transfer pertama / First transfer date *
MM
/
DD
/
YYYY
Durasi / Duration *
Metode pembayaran / Method of Payment : *
Nama / Name *
Your answer
Alamat / Address : *
Your answer
Kota / Suburb : *
Your answer
Negara / State / Country : *
Your answer
Kode pos / Postcode : *
Your answer
Telepon / Phone : *
Your answer
Email : *
Your answer
Saya menyetujui pengurus Indonesian Ukhuwah Centre (IUC) dapat menghubungi saya untuk mengingatkan tentang donasi ini. Saya dapat merubah donasi ini di kemudian hari dengan menghubungi pengurus IUC. Mohon untuk mengirimkan bukti transfer (email: info@iucwa.org.au | WA: +61 490 182 114 | +61 490 113 173) untuk pembukuan internal.
I agree Indonesian Ukhuwah Centre (IUC) representatives to contact me to remind me about my pledge. I understand that I may change my pledge amount by contacting IUC representative. Please send the transfer receipt to (email: info@iucwa.org.au | WA: +61 490 182 114 | +61 490 113 173) for internal bookkeeping.
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