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Locks of Hope Form

The document provides information about donating hair to be made into wigs for cancer patients. It details the hair requirements, donation process, costs to make a wig, delivery status updates, and how to request an e-certificate of donation.

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jacq0429
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180 views

Locks of Hope Form

The document provides information about donating hair to be made into wigs for cancer patients. It details the hair requirements, donation process, costs to make a wig, delivery status updates, and how to request an e-certificate of donation.

Uploaded by

jacq0429
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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HAIR + CONTRIBUTION = WIGS

Full Name : _________________________________ IC No : ___________________________

Address : _________________________________________________________________________

_____________________________________________ Postcode : _______________________

Mobile No : ______________________ Email Address: ________________________________

Extra Contribution (optional) :


Want to help us to raise funds? Be a fund raiser in Simply Giving (www.simplygiving.com/locksofhope).
I would like to to be volunteer in helping the cancer patients !
I would like know more about being a member. Please email me the info.

1 How to Donate ? 2 Cost to Make a Wig - RM800


1) Hair requirement :
Length: At least 6 inch/15cm. I would like to donate to Locks of Hope by:-
Condition : Dry, colored/perm/rebonding Cash : RM
please donate after 6 months. Cheque : No
Online Transfer : Hong Leong Bank 21500045722
2) Go to any salon (or we recommend our salon partner) (Please provide slip)
Debit/Credit Card :www.simplygiving.com/Non-Profit/locksofhope
3) Tie a ponytail with a rubber band and cut it.

4) Mail this form, contribution and hair to our office: DONATE RM 1 CAMPAIGN
We thank you for sacrificing your hair for the cancer patients’ need,
Locks of Hope Association unfortunately we need more fund to make more wigs for cancer
N0.29-2, Jalan Temenggung 19/9, Sek 9, patients..
Bandar Mahkota Cheras,
43200 Cheras, Selangor. Malaysia
[For own delivery, please pass to KH Mobile Shop (G floor)]. 3 Delivery Status
1) For Courier Service, please check with the online delivery status with the
* We have only 1 office in the world. tracking code provided OR
Do not send or give to third party.
2) We will post name list in the facebook after we have process the parcel,
please wait patiently for us to reply you.
Donor Signature :
4 E-Certificate
If you would like to receive e-certificate, kindly check the Monthly Hair Donor Name
____________________ List shared in our Facebook page. Once you find your name, you may then email
( Name & IC no) to locksofhope2014@gmail.com to request for e-certificate.
Date of Donation :
By signing this, I hereby confirm that I willingly agree to donate my hair **Any further Please contact +6010 - 806 2447 (Please leave a message if no pick up)
to the Locks of Hope Association with the intention for the collected hairs
to be turned into wigs for cancer patients undergoing chemotherapy. question ? OR email to locksofhope2014@gmail.com

Thank you for your donation. You have no rights to change, forge, edit this hair donation form format for any reason.
All are advice to fill up the form for hair donation or contribution. V 5.0

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