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Donation Form

Note: Fields marked by an * are required.

Full Name/
Company

Title

Address

Postcode

City

State*

Country *

Telephone*

Mobile Phone

Fax

Email*

Nationality

Malaysian

Non-Malaysian

Amount(RM)

Remarks

For whom:*

Payment
Method

You may make your donation payment via the following options:

Cheque

Write a cheque to YMCA Kuala Lumpur or visit our counter

Direct Bank In

Name: YMCA KUALA LUMPUR
Maybank Acccount : 514039330191
EON Bank : 0061-10-001246-5
Transaction Description: DONATION

After bank-in, please write your name and Contact No. on the bank slip and fax/email to:

Ng Sok Pan Fax : 603-2274 0559 Email : sokpan@ymcakl.com Tel : 03-22741439 ext 111