ADOPT A MOTHER AND SAVE HER CHILD

You can contribute towards CINI's Adopt a Mother and Save her Child programme by mailing a cheque to the address that will be displayed once you submit this form or by donating online using your credit card through our secured payment gateway. 

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Payment Details

I would like to pay a one-time donation to adopt a mother. 
*I would like to adopt 

*Amount per mother Rs 15 000*
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Personal Details

*Title
*Name

Date of Birth
Organization

*Address
*City
*State
*Zip/Pin code
*Country
Email
*Telephone (R)
Telephone (O)
Cell Phone
Fax
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