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| HCHW
Credit Card Payment Form |
| Credit
Card Payment Form for VISA ans MASTER card |
Please
fill in the form and print it before mailing to the given address
below |
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Name |
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Address |
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City |
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State |
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Zip/Pin
Code |
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Phone |
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E
mail |
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| Yes!
I would like to donate towards HCHW Zakat Fund an amount of |
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Rs
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Credit
Card Type |
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Date
of Expiry |
DD
M
Y
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Credit
Card No |
Date of birth DD
M
Y
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Place
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Date DD
M
Y
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| Please
credit the said amount to HCHW's ICICI bank A/no:- 008701018157 |
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| Signature:
_____________________________
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| Please
mail the form to the address below: |
| ……………cut here to use below
text as address label…………… |
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| Hyderbad
Council of Human Welfare,
12-2-790/56, Ayodhya Nagar Colony
Mehdipatnam, Hyderabad - 500028
Andhra Pradesh - India
Phone : +91-40-23526554, 55505827
Fax : +91-40-23526674
Email :hchw_in@hotmail.com
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