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DONATION FORM Donor’s Particulars Please tick the appropriate boxes and complete the donation form.

Full Name (Mr/Ms/Dr) Organisation/ Lions Club of Singapore NRIC/FIN/UEN* Email Mailing Address

Mobile

* Required for tax deduction purpose. * All outright donations of $50 and above are eligible for 2.5 times tax deduction. Please DO NOT enclose cash.

By providing the information, I/we agree and give consent to the Lions Home For The Elders, as well as its representatives and agents (collectively “LHE”), to collect and use my/our personal data, as well as from time to time, disclose such personal data to LHE’s authorised service providers, and relevant third parties for purposes reasonably required by LHE to process my/our donation to LHE. Such purposes are set out in the Data Protection Policy (www.lionshome.org. sg/data-protection-policy), which I/we confirm I/we have read and understood.

One-time Donation

Monthly Donation

$50

$100

$350

$500

Other Amounts

Donate by Debit/Credit Card (Visa/MasterCard)

Card Holder’s Name Card No. Expiry Date (MM/YY)

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Donate by Cheque Cheque to be crossed and made payable to ‘Lions Home For The Elders’. Bank Name Cheque No.

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