LUGDAA DONATION FORM


Donor Name:              ___________________________________________________



Post-Graduation Year: __________________________________________________



Address:                      ___________________________________________________



                              ___________________________________________________



Email:                          ___________________________________________________



Phone:                         ___________________________________________________



Purpose of Donation:


___________________________________________________________________



____________________________________________________________________



Please make checks payable to:

LUCKNOW UNIVERSITY GEOLOGY DEPARTMENT ALUMNI ASSOCIATION

INDIAN OVERSEAS BANK
BSIP Branch
53 UNIVERSITY ROAD
LUCKNOW 22607

Account:  187301000002592
IFSC Code: IOBA0006667
SWIFT Code: IOBAINBB207



Check Amount:           __________________            Check#: ____________________



____________________________________            ___________________________

Signature                                                                    Date



Please email this form as an attachment to:

rameshbali@rediffmail.com
dhruvsensingh@rediffmail.com

and copy to:
lugdaa@yahoo.com


Note: All donations to LUGDDA are 100% income tax exempt in India as applicable to individuals.