AIDS Solidarity Fund Monthly Donation Signup Form

Monthly Donation

^RM20^{/ monthly}

^RM40^{/ monthly}

^RM60^{/ monthly}

People Living With HIV (PLHIV) will consume 4 tablets Daily.

I would like to make a MONTHLY DONATION

Other Amount

Please donate whatever you can to help us.

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Name *

First

Last

IC No *

Contact No *

Email *

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Mode of Payment

Credit/Debit Card No

Name on Card

Expiry Date

All donation above RM50 are tax deductible under Malaysian law. Exempted from income tax under subsection 44(6) Income Tax Act 1967.Ref.JHDN.01/35/42/51/179-6.4095.
Earn Maybank Treatpoints when you use your Maybankard to donate to the Malaysian AIDS Foundation.

Please let us know if you'd like to receive communications materials from us:

I agree that MALAYSIAN AIDS FOUNDATION may contact me via direct mailers, newsletters, telephone and electronic communications (including e-mails and e-newsletters) for updates and/or fundraising purposes.