我樂意捐款支持「健康快車」。

I would like to make a Donation to support Lifeline Express!

Please fill in all * Required blanks

捐款金額 Donation Amount *

是否需要捐款收據 Do you need a receipt? *

若收據抬頭名稱與捐款者不同,請註明。 If the recipient‵s name is different from Donor, please specify:

(捐款 HK$100 或以上可憑收據申請扣減稅項 Donations of HK$100 or above are tax deductible with a receipt)

捐款人資料 Donor Information *

稱呼 Salutation

姓名 Name / 公司 Company *

捐款者編號 Donor No. (如適用 If applicable)

地址 (如需要收據,必須填寫) Address (Mandatory if donation receipt is required)

地區 District:

街道 Street/Road:

大廈 Building:

樓層 Floor:

室 Room:

電話 Tel: *

電郵 Email


 

以上收集之聯絡資料只供健康快車香港基金寄發收據、募捐及通訊之用,絕對保密。

The above Personal data collected by Lifeline Express Hong Kong Foundation will be kept strictly confidential. The data will be used for our receipt issuing, fund raising and communications purpose only.