Butuan City Charities Foundation
Donation Form
Personal Details:
- Name : _____________________________________
- Address :
- No. & Street:____________________
- City :____________________
- State :____________________
- Country :____________________
- Telephone : _____________________________________
- E-Mail : _____________________________________
Would you like to donate to a specific project?_____
- ______________________________ $________________
- ______________________________ $________________
- ______________________________ $________________
- ______________________________ $________________
For donations via credit card, please fill-in the
following information:
This is to authorize BCCF to charge my donation to my
Credit card No. :____________________________
Expiration Date :____________________________
Amount of Donation: One time :_________________
Monthly :_________________
Printed Name :____________________________
Signature :____________________________