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To mail your check or money order, just print one of the forms below:
 Donate/Join/Renew Form ~ 100kb
Gift Membership Form ~ 51kb
Memorial/Honorary Gift Form ~ 67kb
... fill out the information, and mail to:
Society for Appropriate Rural Technology for Sustainability (ARTS)
P6 Cluster 2, Purbachal, Salt Lake
Kolkata 700097, INDIA.
If you have questions, please call us at:
Phone: +91 (33) 2335-9812
Mobile: +91 9339259812
e-mail: info@sankalpacmfs.org
If you cannot open PDF documents, please print and mail the form below.
* Indicates a required field.
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| Type Of Donation: |
| Join |
____ |
| Renewal |
____ |
| Student and Youth Membership |
____ |
| Gift Membership |
____ |
| |
Notify recipient____Yes ____No |
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| |
Occasion____________________ |
| Monthly Giving |
____ |
| Memorial Gift |
____ |
| Honorary Gift |
____ |
| Additional Gift |
____ |
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| *Donation Amount: |
| $25 ____ | |
Rs.100 ____ |
| $50 ____ | |
Rs.250 ____ |
| $75 ____ | |
Rs.500 ____ |
| $100 ____ | |
Rs.1,000 ____ |
| $250 ____ | |
Rs.2,000 ____ |
| $500 ____ | |
Rs.5,000 ____ |
| Other $____ | |
Other Rs. ____ |
|
| |
| Your Name & Email |
| *Email: |
____________________ |
| *Prefix: |
____________________ |
| *First Name: |
____________________ |
| Middle Name/Initial: |
____________________ |
| *Last Name: |
____________________ |
| Suffix: |
____________________ |
| |
| Billing Address |
| *Address Line 1: |
____________________ |
| Address Line 2: |
____________________ |
| *City: |
____________________ |
| * State/Province: |
____________________ |
| *Zip/Postal Code: |
____________________ |
| *Country: |
____________________ |
| |
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| |
| Phone Contact |
| Home Phone: |
____________________ |
| |
| ____ |
Check box if your current address is the same as your permanent address. |
| Mailing List Subscriptions |
| Subscribe to: |
| ____ |
Online Alerts
Sign-Up to receive action alerts from Sankalpa cMFS coalition partners on urgent projects that need your immediate help and attention. |
|
| ____ |
Sankalpa Newsletter
Receive news, items of interest, and action alerts from Sankalpa cMFS coalition partners. The newsletter is currently published on a quarterly basis. |
|
| ____ |
Please send me updates about upcoming Special Offers, Events and Membership Opportunities. |
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| |
| Payment Information |
| *Card Type: |
____ Visa
____ MasterCard
____ American Express
____ Discover
|
| *Card Number: |
____________________ |
*Expiration Date:
|
____________________ |
| |
| Permanent Address |
| *Email: |
____________________ |
| *Address Line 1: |
____________________ |
| Address Line 2: |
____________________ |
| *City: |
____________________ |
| * State/Province: |
____________________ |
| *Zip/Postal Code: |
____________________ |
| *Country: |
____________________ |
| Phone: |
____________________ |
| School: |
____________________ |
Graduation Date
(mm/yyyy e.g. 05/2005): |
____________________ |
| |
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| Please complete the sections below if you are making a Gift or Honorary/Memorial donation. |
| Recipient Name & Email |
| Email: |
____________________ |
| *Prefix: |
____________________ |
| *First Name: |
____________________ |
| Middle Name/Initial: |
____________________ |
| *Last Name: |
____________________ |
| Suffix: |
____________________ |
| |
| Recipient Home Address |
| *Address Line 1: |
____________________ |
| Address Line 2: |
____________________ |
| *City: |
____________________ |
| *State/Province: |
____________________ |
| *Zip/Postal Code: |
____________________ |
| *Country: |
____________________ |
| |
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| Recipient Phone Contact |
| Home Phone: |
____________________ |
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After you have printed and completed this form, please mail with your payment to:
Society for Appropriate Rural Technology for Sustainability (ARTS)
P6: Cluster 2, Purbachal, Salt Lake
Kolkata 700097, INDIA.
Phone: +91 (33) 2335-9812
Mobile: +91 94330 19821
e-mail:info@sankalpacmfs.org
THANK YOU
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