Application of Credit Card Donation

To：Children's Hour Campaign Administration Office C/O IYF-Japan

FAX: 03- 3440- 4447

Name:
*Please indicate your name registered to the credit card company.

Address:

City: State:
Zip:

*Please indicate your address registered to the credit card company.

Contact Phone no：

Daytime Contact Phone no:
*Please write the phone number registered to the credit card company, and the daytime contact phone number.

E-mail:
*Receipt confirmation and campaign notes will be submitted through email.

Amount of Donation: Yen

Credit Card Company　

Card no（16 digit number） ---

Expiration Date（MM/YY） /

*Please contact us if you do not receive a confirmation note within 2 days.

◆For further information, please contact◆
Ms.Murakami, Children's Hour Campaign Administration Office C/O IYF-Japan
TEL: 03-3440-3373, FAX: 03-3440-4447,
E-mail.〈info@iyfnet-jp.org〉

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