ANIMAL DISASTER RELIEF FUND
DONATIONS FOR VICTIMS OF THE SICHUAN EARTHQUAKE
May 19, 2008
The International Center for Veterinary Services is collecting RMB cash donations that will be
turned over to the PRC government agencies coordinating the relief effort for animals and pets
affected by the Sichuan earthquake. Kindly fill out this form along with your donation. All
donations will be recorded and tracked. If you wish to make an anonymous donation, kindly fill
out the amount and write in “Anonymous” under name of donor section. Thank you very much for
your kindness and support!
Name of individual donor
个人捐款者的名字Last name, First name 姓名
Name of donor organization
单位捐款者名称
Nationality 国籍
Passport or ID number
护照或身份证号
Mobile number
手机号
电子油箱
RMB donation amount
人民币捐款额
International Center for Veterinary Services
No. 29 Liang Ma Qiao Lu, An Jia Lou
Chaoyang District, Beijing 100125
Tel: (8610) 8456-1939/1940/1941
Fax: (8610) 6433-2301
Email: ICVS_CHINA@yahoo.com
Web site: www.ICVSASIA.com
救助受灾动物基金
为四川地震中受害者捐款
2008-5-19
北京新天地动物医院现正在为解救四川地震中受难的动物和宠物募集捐款。捐款形式为人民币现金。这些捐款将全部
移交给中华人民共和国政府用于受灾动物拯救。请您在捐款的同时填写这张表格，所有的捐赠都将有记录可查。如果
您希望匿名捐款，请在捐款者名字一栏填写“匿名”并填写捐赠金额。非常感谢您的善举和支持！
Name of individual donor
个人捐款者的名字Last name, First name 姓名
Name of donor organization
单位捐款者名称
Nationality
国籍
Passport or ID number
护照或身份证号
Mobile number
手机号
电子邮箱
RMB donation amount
人民币捐款额
北京新天地国际动物医院
北京市朝阳区安家楼亮马桥路29号
肯特中心 邮编：100125
电话: (8610) 8456-1939/1940/1941
传真: (8610) 6433-2301
电子邮箱: ICVS_CHINA@yahoo.com
网站: www.ICVSASIA.com
