Donation Form
:
COMPANY'S NAME:* :
MAILING ADDRESS:* :
PIN CODE* :
E-MAIL* :
TEL NO:* :
Billing State :
Billing Zip Code :
Billing Country :
Mobile No. :
Email :
Mobile No. :

i would like to make a* Donation of Rs. by** Demand Draft/Cheque No.
drawn on dt. .


*Donations to Thalassemics India (Regd.) are exempt under Section 80-G of the Income Tax Act.
Please mail your donation along with this form to:
Thalassemics India
A-9, Nizamuddin West, New Delhi-13
Tel: 41827334, 46595811
E-mail : thalcind@yahoo.co.in
Website : thalassemicsindia.org

(You can also donate online by going on to the payment gateway on our website.)
**Cheque/ DD to be made in favour of Thalassemics India (DD to be made payable at Delhi)