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寒冬送暖❤物資大募集 認捐表單
請務必填妥資料。謝謝您的愛心❤
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捐助者1
姓名
*
Your answer
認捐箱數(一箱2000元)
*
Your answer
捐助者2
姓名
Your answer
認捐箱數(一箱2000元)
Your answer
捐助者3
姓名
Your answer
認捐箱數(一箱2000元)
Your answer
捐助者4
姓名
Your answer
認捐箱數(一箱2000元)
Your answer
捐助者5
姓名
Your answer
認捐箱數(一箱2000元)
Your answer
您的電話
*
Your answer
收據收件地址，會開立收據寄到府上
*
Your answer
收據上要寫的姓名
*
Your answer
您認捐的總金額
*
Your answer
備註(公司統編等皆可於此處付上)
Your answer
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