Sponsor A Child

Thank you for your intention to support
Broto Seno Setyo Nugroho.
to make a payment for sponsoring THIS child,
please transfer to the bank account below

Please Fill this Form below (min. Donation IDR 200.000)

Title *	Mr. Mrs. Ms.
Name of Donator *
Date of Birth *
Place of Birth *
Addres *
Email Address *
Phone Number *
Pin BB/WA
Name of Your Supported Child *
How often would you like to make the payment : *
	IDR 200.000 every 1 month IDR 600.000 every 3 months IDR 1.200.000 every 6 months IDR 2.400.000 every 1 year
Payment Method *
	*If using Doku, You will redirected to doku ppayment page after submit this form.
	I'd like to receive Ant's Charity updates via email

BCA

Agustin Ramli (Founder)

7530158882

Mandiri

Yayasan Ant Charity

1190011082011

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