If you are a human and are seeing this field, please leave it blank. Fields marked with an * are required Salutation Mr. Mrs. Ms. Mdm. Dr. M/S My/Our Particulars Name (as in NRIC/FIN/Uen) * NRIC/FIN/Uen No * Mailing Address * Contact Person * Contact No (Handphone) * Contact No (Home) Contact No (Office) Email * I/we would like to donate * Monthly One Time Amount (S$) * $10$20$50$100$200$500Other If Other, Please Enter Amount DONATION VIA (Please tick accordingly) Cheque Cheque Number Name of Bank Please make your cheque payable to “SAVH” and mail the cheque to: Singapore Association of the Visually Handicapped 47 Toa Payoh Rise Singapore 298104 CREDIT CARD Visa/MasterCard Number Expiry date (mm/yy) Name on Credit Card Your preferred channel of communication is via Phone CallEmail Remark *Please provide your NRIC/FIN/Uen number for processing the tax deduction receipt to be automatically included into your tax assessment by IRAS. The tax deduction receipts will be issued to donations above S$50 unless requested. By submitting this form, I fully understand and consent to the collection, use, disclosure and retention of my personal data for the purposes of processing donations, performing donor relations activities, carrying out our fundraising appeals and events, send marketing communication materials and submission of donation data to the Inland Revenue Authority of Singapore (IRAS) for tax-deduction computation in accordance to the terms stated in SAVH's Data Protection Policy (A copy of which is available at www.savh.org.sg). I confirm that all information and details here are true, correct and complete and SAVH will maintain the information confidentially and will not use my personal data for other purposes.