Donation / Sponsorship Proforma

All the donors kindly note that the contribution made to our Organization, towards the Rehabilitation of the Disabled and Aged will be gratefully acknowledged and their names will be prominently displayed at the center.
I wish to Donate/ Sponsor and associate myself with the organization and I am willing to donate/ sponsor:

• Special Annadhanam Scheme :
  
  • Contribute Rs.5,00,000/-, (Rupees Five Lakh only). (US $10,000) by way of a Fixed Deposit in the name of the Organization and the interest gained will be used for entire days meal (Breakfast, Lunch & Dinner), once in a month, for the Beneficiaries.
  • Contribute Rs.2, 50,000/-, (Rupees Two Lakh Fifty Thousand only)(US $5000) by way of a Fixed Deposit in the name of the Organization and the interest gained will be used for the entire days meal (Breakfast, Lunch & Dinner), once in Three month, for the Beneficiaries.
  • Contribute Rs.1, 00, 000/-(Rupees One Lakh only) (US $ 2000) by way of Fixed Deposit in the name of the Organization and the interest gained will be utilized for providing, the entire days meal (Breakfast, Lunch & Dinner), once in a year, for the Beneficiaries.
  • Contribute Rs.50, 000/-(Rupees Fifty thousand only) (US $ 1000) by way of Fixed Deposit in the name of the Organization and the interest gained will be utilized for providing one meal (Lunch), once in a year, for the Beneficiaries.

Special Meal Program

* I Prefer Month		Date
* Please specify your choice of day and date.

Other Donations

• Corpus Fund : Contribute Rs. 5,00,000/- (Rupees Five Lakhs Only)(US$ 10,000)by way of Fixed Deposit in the name of the organization and the interest gained will be utilized for day- to-day expenses (eg: food materials ,water and electricity charges ,gas ,etc etc).
• Vehicle Fund : Contribute Rs.5, 00,000(Rupees Five Lakhs Only) (US $ 10,000) to construct a room or purchase a transport vehicle for the use of Mentally Challenged and Senior Citizens in the orgazation.

Enclosed Rs/US $ ______________ (Rupees/Dollars) ______________________________.
D.D/*Cheque/Cash _______________ No _______________________ Dated _____________.
Drawn on Bank and Branch____________________________________________________.
Towards item No.
Please add Rs.50/-(US $ 20) towards Bank Charges.
Station : ________________Signature : __________________.
Date : __________________ Name : ______________________.
Address : ___________________________________________________
___________________________________________________
___________________________________________________.
E-Mail : ___________________________________________________.
Phone : ___________________________________________________.

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