KING EDWARD MEMORIAL HOSPITAL

Seth Gordhandas Sunderdas Medical College

Acharya Donde Marg, Parel,
Mumbai 400 012. India.
Tel.: 91-22-2410 7000 Fax: 91-22-2414 3435

Diamond Jubilee Society Trust (DJST)

KNOW YOUR DONORS APPLICATION FORM

KNOW YOUR DONORS APPLICATION FORM  for Indian













(Passport/ Voter card)




E. If the donor is a Non Government Organization (NGO)

a. Registration number of the NGO: (Kindly attached copy of registration certificate)

:Govt. of India

:State of Maharashtra

b. If the NGO is an International organization, the letter of recognition from Union of India :
YesNo

c. Key person to be contacted (with designation) :

d. Copy of Memorandum of Association, Article of Association, Constitution document
(if donation exceed Rs. 25 Lacs) :

e. Letter of intent mentioning the source and purpose of donation :

f. Signature :

g. References/Contact with KEM/DJST (if any) :

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