LAA Saturday Free Clinic Sponsorship Form

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LOYOLA ALUMNI ASSOCIATION
Ground Floor, Inigo Block, Loyola School Campus, Jamshedpur – 831 001
Phone : 0657-2231199
Offer to Sponsor – Saturday Free Clinic
I would like to Sponsor the Saturday Free Clinic run by Loyola Alumni Association.
Name of the donor:
______________________________________________________
Address:
______________________________________________________
______________________________________________________
Telephone: (R)
(O)
(M)
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I/we would like to sponsor ______ week/s of the Saturday Free Clinic.
Total amount: @ Rs 1,500 x _____week/s. = Rs _________________
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The following may please be displayed at the Clinic for the week/s.
Sponsored by:
____________________________________
In loving/living memory of:
____________________________________
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Donations to Loyola Alumni Associations are exempted U/s 80 G of the IT Act 1961 vide
letter reference no. CIT / TECH / 80G / 2005-2006/ 109-12 dated 14th Oct. 2005.
All Cheques or Demand Drafts are to be prepared in the name of “LOYOLA ALUMNI
ASSOCIATION” payable at Jamshedpur.
Date: ______________________
Place: ______________________
Signature:
______________________
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