Donation Form
Thank you for donating to us.
We need you to fill in this form for donation above $150, as a record for your size, choice of color, and shipping address.
Your email address: *
Your answer
Amount of your donation: *
Your answer
Your donation was transferred using... *
Under whose name/account your donation was made? *
Your answer
What is your preferred color? *
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What is your preferred size? *
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Please inform your complete address below. (Name, Complete Address, Phone number - required for Indonesian address, ZIP Code) *
Your answer
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