Please kindly print this form and then fill it in and send it to us, together with your cheque or bank-in slip. Our address is: Teacher of Ten Thousand Generations Foundation, 3804 Hopewell Centre, 183 Queen's Road East, Wanchai, Hong Kong .

I would like to contribute to TEACHER OF TEN THOUSAND GENERATIONS FOUNDATION in support of the education of needy children in China .

Payment method

Cheque enclosed for _________________.*

(Payable to “Teacher of Ten Thousand Generations Foundation Limited”)

Bank Transfer for____________________ .*

Name of Beneficiary: Teacher of Ten Thousand Generations Foundation Limited

Banker: The Hongkong and Shanghai Banking Corporation Limited

Bank Address: HSBC Main Building , 1 Queen's Road Central, Hong Kong

Account Number: 808-009955-001

Swift code: HSBCHKHHHKH

Personal Details

*

Mr.

Miss

Mrs.

Surname *

First name *

Name to be printed on the receipt

(If different from the above)

Passport / ID No.

(To avoid duplication of donor record)

Donor ID No.

(If applicable)

Donor Receipt Mailing Address

Tel (Day time) *

Fax

Email Address *

(Please provide an email address to receive an online acknowlegement of your donation)

Personal Details (continued)

Occupation

Age Group

18-25

26-35

36-45

46-55

56-65

Above 65

* = Required entries

Remarks

The data collected will be treated in strictest confidence and will be used for receipting and fundraising purposes only.