Support Us
“Society for National Integration for Rural Development”- (SNIRD) Credit Card Payment Form |
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Credit Card Payment Form for VISA and MASTER card | |||
Please
fill in the form and print it before mailing to the given address below |
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Name | |||
Address | |||
City | |||
State | |||
Zip/Pin Code | |||
Phone | |||
E mail | |||
Yes! I would like to donate towards Society for National Integration for Rural Development (SNIRD)an amount of | |||
Rs | |||
Credit Card Type | |||
Date of Expiry | DD M Y | ||
Credit Card No |
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Date of birth | DD M Y | ||
Place | |||
Date | DD M Y | ||
Please credit the said amount to “SNIRD “ | |||
Signature: _____________________________ | |||
Please mail the form to the address below: |
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…………………………cut here to use below text as address label………………………… |
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Society for National Integration for Rural Development (SNIRD) Tel : +91-08592 – 232008 / 228336. |