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Donation Payment Confirmation
Please fill the form below so we can confirm your donation
Confirmation through proof of transaction
BROWSE IMAGE
or
Confirmation through transaction data
Payment Date
Payment Amount
Select Our Bank Account
- Select Account -
Bank Mandiri - 123 123 1234 (a/n : Test Nama Rekening)
Bank Mandiri - 123 123 1235 (a/n : Bentara Papua)
Bank Mandiri - 123 123 1236 (a/n : Bentara Papua)
Customer Bank
(ex: BCA, Mandiri, etc)
Customer Account No.
(ex: 1234567890)
Customer Account Name
(ex: Michelle, Phillip, etc)
Note
Dapatkan Informasi dan Update Terbaru dari Kami
