How You Can Help

 

 

I would like to contribute

To Human Life Service

Full Name : Company / Organization / Mr / Mrs / Ms ______________________________

Address : _______________________________________________________________

             _______________________________________________________________

Tel. no. : _____________________________(H) _____________________________(O)

             (H/P)____________________________ Fax no.: _______________________

Mobile Phone __________________________

E-mail __________________________________ Please tick one of the following boxes :

I would like to pledge RM_____ per month for ____ months / year(s)

Enclosed is crossed cheque / bankdraft / money order no. _____________________

Please make cheque payable to Human Life Service and post them to:

Human Life Service,

P.O.Box 37,98000 Miri,

Sarawak, East Malaysia

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