Make a donation by credit card

1. First name
2. Last name
3. Email address
4. Phone number
5. Home address
6. Donation amount (in Japanese Yen)
7. Would you like to have a receipt issued by Ban Rom Sai? Yes / No
   * Receipt from Square Inc. will be sent you automatically once your transaction has been completed.

After we receive your message, we will send you an invoice to your email account via Square, Inc. Please follow the link on the invoice to make the payment.

Foreign transaction fee: Please be noted that all credit card transactions will be processed in Japanese Yen.
Foreign transaction fee might be applied depending on the credit card company.