The donation process｜ashinaga.org

The donation process

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Note: Fields marked with an asterisk (*) are required.

Donor information

Name ※	First Family
Sex ※	M F
Year of birth	Please use 4-digit format (e.g., 1975).
Postal code ※	-
Prefecture/province/state ※
City ※	市区町村をご入力ください。
Address line 1 ※	市区町村以降の住所をご入力ください。
Address line 2	アパート名・建物名とお部屋番号をご入力ください。
Address line 1 ※
Address line 2
City ※
Prefecture/province/state ※
Postal code(up to 15 characters). ※
Country ※
Telephone number(up to 20 digits). ※	Enter using single-byte numerals.
E-mail address ※	Enter using single-byte alphanumeric characters. To confirm your e-mail address, please enter it again.
Is this the first time you have donated to Ashinaga?	Yes No Note: For other than first-time donors, please enter your donor ID, if known (a 10-digit number beginning with 1 through 5). Donor ID:

Donation details

How would you like your donation used? ※	Ashinaga Japan - support Japanese students Ashinaga Japan - the AAI & local programs Ashinaga Uganda - local programs & AAI camp Ashinaga Brazil - AAI in Brazil
Donation amount ※	The minimum donation is 500 yen. Please do NOT use a comma to separate digits. yen
Delivery of donation certificate and program report	May we send you an annual donation certificate and program report? Yes No
Delivery of receipt for donation	While we will send an annual donation certificate listing the total of all your donations during the year, in order to minimize costs we normally do not issue receipts for individual donations. If you require an individual receipt, please indicate below. I do not need an individual receipt. I do need an individual receipt. Note: The date of the receipt will not be the date funds are deducted from your account, but the date that your donation is received by Ashinaga.

Credit card details

Card number ※	Please do not use hyphens or spaces.
Expire date ※	Month Year
Security code ※	The security code generally consists of the last 3 or 4 digits following the card number printed on the reverse of the card (American Express security codes appear on the front of the card).

The following credit cards may be used.
We accept the credit cards with the following brand marks.

Bank account Information

Bank code ※

Bank account Information

Bank user_name ※	全角カタカナで入力して下さい。

Convenience Information

Convenience ※

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Please feel free to send a message to the orphans your donation will help. (Max.: 3,000 characters)

Message

We would be grateful if you could take a few minutes to complete the following survey.

How did you hear of this Web site?	Newspaper TV Radio Magazine Street-corner fundraising P-Walk Search engine At a lecture or similar function Exhibition Ashinaga mailing From a friend Other

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.