Pledge Form
I :  
Date of Birth :   (dd/mm/yyyy)
Address :  
City :
State :
Country :
Pin Code :  
Phone No (Residence) : -
Phone No (Office) :   -
Mobile :  
e-mail id :  
Name of next to kin :  
Contact of next to kin :  
The information furnished above is correct to my knowledge
Remember one donation restores sight, the most precious gift of god, to two people!

You do not have to pledge your eyes to help some one…you just need to open them. Any contribution you make will help someone see their world through your eyes!

Niramaya welcomes support of all kinds – voluntary time, suggestions for improvement, professional input besides monetary donations.

Please fill up the form below and pledge your eyes, so that they can see long after you are gone.




All rights reserved.
About Us     |      Projects      |      Contribute      |      Info Bank      |      Contact
pledge
Donate for Gurgaon Carnival 2011
For Donations from within India please contact here