Online Donation Form
 Country of Residence *
 Full Name *
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 Email ID *
 Address *
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   I declare that I am an Indian citizen, above 18 years of age and am making this contribution voluntarily from legally earned personal funds. I also permit Samarpan Team to communicate with me using my phone and/or email specified above. The particulars and statements made above are correct to the best of my knowledge and nothing has been concealed or withheld.