Donation Form for Supporting the Maha Chakri Sirindhorn Foundation
I would like to make donation in cash of
 ........................................................Baht
To be allocated as follows:
 Furniture and audio-visual aids for classrooms*
 80,000 Baht
 90,000 Baht
 120,000 Baht
 140,000 Baht
 160,000 Baht
 220,000 Baht
 Multi-media systems*
 500,000 Baht
 600,000 Baht
 Audio-visual aids**
 20,000 Baht
 40,000 Baht
 50,000 Baht
 70,000 Baht
 85,000 Baht
*Name plates bearing the names of donors of classroom furniture and audio-visual aids
and multi-media systems will be affixed to the rooms.
**Name plates bearing the names of donors of audio-visual aids will be affixed to the
equipment.
First name.........................Family name............................../Faculty of Arts Year.................
Address................................................................................................................................
...........................................................................................Telephone number.....................
Work…..................................................................................................................................
...........................................................................................Telephone number.....................
Mobile telephone....................................... E-mail..................................
Payment Options
 Transfer money from bank account or ATM to savings account, Siam Commercial
Bank, Suan Jitralada Branch.
Account name the Maha Chakri Sirindhorn Foundation for the Faculty of Arts,
Chulalongkorn University
Account number 067-2-10747-4
Transfer from Branch……….........................Date......./......./.......
Name of donor...........................................................(Please attach a transfer slip)
 Send personal cheques or cashier cheques payable to the Maha Chakri Sirindhorn
Foundation for the Faculty of Arts, Chulalongkorn University, crossed A/C PAYEE only
or crossed “or bearer”
 Postal orders payable to the Maha Chakri Sirindhorn Foundation for the Faculty of
Arts, Chulalongkorn University at Chulalongkorn University Post.
Post Order No……………………………………
Your donation is tax deductible.
Please send this form back by Fax : 02-2184885 or by mail to
the Maha Chakri Sirindhorn Foundation for the Faculty of Arts, Chulalongkorn
University
The Dean’s Office, The Maha Vajiravudh Building, Faculty of Arts
Chulalongkorn University, Pathumwan Bangkok 10330