Donor Information

Donation Information

Payment Information

Confirmation of input information

Donations accepted completion


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* are required field.

Donor Information

Name(as it appears on the card) * First    Family 
Postal code *  -    
State / Province *
City *
Example: Minato-ku
Street *
Example: 6-10-11 Minami-Aoyama
Building
Example: Wesley Center, Room 203
Building
Street *
City *
State / Province *
Postal code *
Country *
Phone Number *
(XXX-XXX-XXXX)
Email address *
Please enter again to reconfirm.
Organization

Donation Information

Your account will be charged in: *




Amount *


 Yen
Please note that the annual ammount of your donation more than 1,000 yen will be appreciated.
Donation purpose *  
 
 
   
Donor Division  
     Year of Graduation / Department : Subject / Postgraduate School : Major 
     
 
     Affiliation / Classification 
 
 
     School : Subject / Graduate School : Major 
 
     Name of Student / School : Graduate School / Year of Enrollment 
     
 
Agree to Publish *  
 
 

Payment Information

We accept the credit cards with the following brand marks. We accept the credit cards with the following brand marks.
Card number *
Please do not use hyphens or spaces.
Expire date *  Month  Year
Security code *   Security Code
Bank code *

振込先は決済代行会社「みずほファクター」と表示されます。
別途振込手数料がかかります。

Bank user_name *
全角カタカナで入力して下さい。
Convenience *
ご利用されるコンビニの変更はできませんのでご注意ください。

Please feel free to send a message to the orphans your donation will help.

We do not use donors' personal information for any purpose other than fundraising, and we implement appropriate measures to ensure the security of all information provided.