Donation Form

Salesian Missions Office - Fr. Larry Tan SDB
C. Roces Cor. A Arnaiz Ave.
1264 Makati, PHILIPPINES
Tel +63 (2) 813-3820 / +63 (2) 893-8227
FAX +63 (2) 813-3811

Donor Information

Name *	:
Telephone Number *:	:
Email *	:

Billing Information

Name on card If different from donor name.	:
Billing Address *	:
		City/Town *:
State/Province *	:	Zip/Postal Code * :
Country *	:

Credit Card Information

Credit Card Type*	:
Credit Card Number*	:	CVV/CVC*:
Expiry Date*	:

Charge my credit card for the amount of:

PHP 1,000
PHP 2,000 PHP 3,000
PHP 4,000 PHP 5,000
PHP 10,000 PHP 20,00
Other

US$ 20
US$ 40
US$ 60
US$ 80
US$ 100
US$ 200
US$ 400
Other

I would like to donate the specified amount once only, or monthly for months, to
Send children to school(Scholarship)
Make dreams come true(Street Children)
Contribute to youth ministry(Special projects)
Support seminarians(Seminary Support)
Help the Missionaries(Salesian Missions)

Signature Date

No gift is too small or too LARGE!

Instructions

Completely fill out this form, then click on "Print This Page" to print on paper.
Sign the print-out.
Send the signed form to the Salesian Missions via one of the following methods:
- By mail. Put the signed form in an envelope and send to
- By fax: Send fax to
- By email: Scan the signed form, and email the scanned image to