Donation Form (* Please delete as appropriate )

/ * $ __________________ I / Our organization* would like to donate HK$ ______________ in support of the work of Caritas - HK.

Particulars of Donor / * Name of Donor _______________________________________________________

( / / / Dr/Mr/Ms/Mrs*)

Contact Person

Contact no. _____________________ Email

Mailing Address

Donation Methods ( “ ” Please tick as appropriate)

Crossed Cheque Please make cheque payable to “Caritas – Hong Kong”

Direct Bank Deposit Donations can be deposited to the following

bank account “Caritas – Hong Kong”

Credit Card Visa Master

Cardholder’s Name ________________________________________

Credit Card No _________________________________________

Expiry Date _________________ Cardholder’s Signature _______________________

Online Donation www.caritas.org.hk Please visit www.caritas.org.hk to make a donation

7-Eleven 7-Eleven outlets

7-Eleven (HK$100-5,000) Please make a donation (HK$100-5,000 per transaction) at any 7-Eleven outlets by presenting this barcode

100 7-ELEVEN

2 603 ; 2523 0438!

A tax-deductible receipt will be issued for charitable donations of $100 or above. If receipt is required, please send the cheque/original bank-in slip/receipt issued by 7-Eleven convenience stores together with this completed form to Rm 603, Caritas House, 2 Caine Road, Hong Kong. For donations through credit card, please send the completed form by fax to 2523 0438 or by mail to the above address. Thank you.

/ “ ” The above information will be used for issuing receipt and contact for this donation only. If you do not wish to receive any further fundraising / publicity materials from us, please put a tick in the box.

For enquiries: 2843 4638

ICBC (Asia) 701-010-001504