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COVID Donation Form
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LetshareIndia Foundation Contact us at (+91) 97694 42469 or
poonamkashyap.lsif@gmail.com
Name
*
Your answer
Email
*
Your answer
Contact Number
*
Your answer
Address
*
Your answer
Birthdate - To send you warm wishes and suggest you to donate in kind
MM
/
DD
/
YYYY
Anniversary Date - To send you warm wishes and suggest you to donate in kind
MM
/
DD
/
YYYY
Mask Quantity
Your answer
Sanitizer Quantity
Your answer
PPE Kit Quantity
Your answer
Hand Wash Quantity
Your answer
Thermometer Quantity
Your answer
Oxymeter Quantity
Your answer
Soap Quantity
Your answer
Steamer Quantity
Your answer
Other Material (Item - Quantity)
*
Your answer
Do you want to make an Anonymous Donation? (Please Note: We do not disclose personal information like email, contact, address but only disclose your Name to the beneficiary)
Yes
No
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Do you need any assistance for shipping the donation item?
*
Yes, I need the recipient or LetshareIndia to arrange the pick up
No, I will ship once I know the recipient details
I understand that I am donating in kind articles which are in the condition that one can use
*
Yes
Required
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