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Dap-Ay Di I-Maeng Fundraising 2010 NGO: Sinbayan Tako Inc. Medical Needs and School Supplies (Donor List) Donor Name

Date

Amount

Signature

Representative: _____________________________ Method of Transmission: Direct Deposit ( ) Western Union ( ) Other ( ) Representative’s Signature: ____________________ Note: Please ensure a copy of this is sent to Dap-Ay Di I-Maeng for record keeping. E-mail: dapaydiimaeng@gmail.com Fax: 1-866-359-1445


Donor List