EmailMe Form - Donate to Daya Cipta Budaya

Donate to Daya Cipta Budaya
Please note that by not filling these form, your donation will appear as anonymous to the charity. Make a donation to Daya Cipta Budaya by transfers to (Mendonasikan untuk Daya Cipta Budaya melalui transfer ke)

Bank Name: Bank Mandiri (Braga Bandung)
Account Name: Daya Cipta Budaya
Account Number (Nomor Rekening): 132-00-1227796-9
For International transfer, use SWIFT code: BMRIIDJA

fields marked * required to be filled

kolom bertanda * wajib diisi

I would like to Donate / saya mendonasikan *

10.00 US $ minimum / IDR 100.000,- minimal

Currency *

IDR

US $

Other

Transfer Date / Tanggal Transfer *

YYYY

Name *

Email *

The Sending Bank Transfers

Bank Pengirim Transfer

Make this a monthly recurring donation
(Jadikan ini sumbangan bulanan berulang)

Optional Data:

kolom di bawah ini merupakan pilihan opsional untuk diisi

Address (alamat)

Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country

Website

Phone Number

Designate my donation to / tujukan pada kegiatan

Enter a description of how you would like your donation to be used.

Dedication my Donation / saya dedikasikan untuk

as gift in some one name or as a memorial

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