This program is an EQUAL OPPORTUNITY for all our adivasi students irrespective of their financial background. Since many adivasi students from rural area cannot afford our nominal fees, they need your support. We request you to give generously and support this program. Please use the form below to donate or/and sponsor. Detach the form and send it to the following address: Dr. Manju Kerketta, Tribalzone. B/2, Dhableswar Housing Complex, Balughat, Panposh, Rourkela, Orissa - 769004
After completion of the
Program, All donors will receive a report on how the program was
conducted and how their money has been spent. Name_____________________________________________________________ Address___________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ Phone_____________________________________________________________ Method of payment (please tick):
Signature______________________________________________ My payment is enclosed (please tick):
c
Cheque of
Rs.
/- payable to ‘Dr.
Manju Kerketta’ (add
Rs. 20/- for non-Rourkela cheques) c Demand Draft of Rs. /- payable to ‘Dr. Manju Kerketta’, payable at Rourkela |
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