Darunee Fund / Asiamerica Foundation -- Donor Slip
Please print this form (on your printer), fill out and mail or fax, with your contribution, to:
Darunee Fund
The Education for Development Foundation (EDF)
50 K.U.A. Building, 3rd Floor, Phaholyothin Road, Jatujak, Bangkok 10900 THAILAND
Telephone: (011) 66 2940 5988    Fax: (011) 66 2940 5266
E-mail: public@edfthai.org     Internet: www.edfthai.org
additional e-mail: usoffice@daruneefund.org
 Darunee Fund (EIN 38-3266227) is a not-for profit, 501(c)(3) organization,  incorporated in Michigan in 1995.
Your donation is tax deductible to the full extent allowed by federal and state tax regulations.

Donor Information
Mr. Ms. Other: Personal Name:   Family Name:
Address: City, State, Zip:
Telephone: Fax: E-mail:
Additional information or request:
How did you hear of us?:

I wish to support the following type and number of scholarships:
Standard Donation - For scholarship & additional school support / rural economic development

A type: Supports one student for 3 years. Tax deductible donation of $300 x

$ total A-type
B type: Supports one student each year for 3 years. $100 per year for 3 years x
(this year only; we will bill you for following years)		 $ total B-type

C type: Supports one student for one year. $100 for one year, tax deductible x

$ total C-type

Special Option Donation - For scholarship only
This type of donation is possible at the present because of the high value of the US dollar. The amount may vary from year to year.

A-s type: Supports one student for 3 years. Tax deductible donation of $180 x $ total A-s type
B-s type: Supports one student each year for 3 years. $60  per year for 3 years x
(this year only; we will bill you for following years)		 $ total B-s type
C-s type: Supports one student for one year. $60  for one year, tax deductible x $ total C-s type
Other General Donation or     Darunee Fund Endowment Donation $

Total Donation Amount:

$
Processing fee (requested of scholarship donors):

$3.00

Total enclosed:

$

Check: Enclosed, payable to Darunee Fund
Credit card  VISA MC AMEX DISCExp Date (mon/year i.e., 03/02)/ 
 Signature:___ _____________________   Cardholder agrees to pay total, per the agreement with credit card issuer.
Cardholder's name & address if different from the donor's name:
                                 
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