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Uddami India Foundation Donation Form

I Wish to Donate the Following Amount to Uddami:
(all donations are tax deductible)

Rs. 100

Rs.1000

Rs.10,000

Other: _______

Please make your cheque out to: Uddami India Foundation

Print out and send this completed form to: Uddami India Foundation
158/4 Prince Anwar Shah Road
Kolkata 700 045 W. Bengal, India

Name: ____________________________

Address:
____________________________

____________________________

City: ____________________________

State: ____________________________

Postal Code: ____________________________

Telephone: ____________________________

Email: ____________________________

Thank You for Your Donation!
We will keep you informed of UCTCs progress by sending you our Newsletter.
If you do not want to receive the Newsletter please check below:

I do NOT wish to receive the Uddami Newsletter EditRegion1

Please make your cheque out to: Uddami India Foundation
Print out and send this completed form to:	Uddami India Foundation 158/4 Prince Anwar Shah Road Kolkata 700 045 W. Bengal, India

	Name:	____________________________
	Address:	____________________________ ____________________________
	City:	____________________________
	State:	____________________________
	Postal Code:	____________________________
	Telephone:	____________________________
	Email:	____________________________