Online Donation

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Donor ID:
HKID: * (First 4 digits ONLY)
Name: *	First Name Last Name
Company Name (if applicable):
Contact Tel No.: *
Mobile No.: *
E-mail: *
Correspondence Address: *




Country/Region: *
Donation Information
Donation Type: *	General Donation High-Risk Breast Surveillance Programme BRCA Ovarian Cancer Drug Programme TP53 Love Follows Assistance Programme Give A Gift Donation Pink Ball Kids Dance Pink Ball Mother Dance Pink Ball Charity Dance Pink Ball General Donation
Donation Amount: * Donation Amount: *	HK $
Receipt Required: *	Yes No
Name on Receipt:
Personal Information Collection Statement
The Registry may use your personal data as above to send you the most updated information related to our services, development and the appeal of donation campaigns through various channels such as direct mailing, email, telephone, SMS or fascimile, etc. All personal data will be kept strictly confidential and handled in accordance with applicable laws. If you do not wish to receive any the above mentioned materials, please tick the box.