Donation Form – Laiba Memorial Welfare Organization

Charity is the best form of service!

Laiba Donation Form

$ Donation Amount:

Donate For *

Donation Follow Up * Email

Duration

Personal Info

First Name *

Last Name

Email Address *

Comment

Credit Card Info

This is a secure SSL encrypted payment.

Card Number *

CVC *

Cardholder Name *

Expiration *

Donation Total: $200.00