Scholarship and Dormitory Donation Pledge for Scholarship and Student Dormitory Name of Donor (required) Address (required) City (required) State or Province (required) Zipcode (required) Country (required) Email (required) Telephone (required) Fax Yes, I hereby pledge to make a contribution to support AIT! Scholarship (Single donor naming recognition) Doctoral (full) - 2,000,000 Baht Master's (full) - 1,200,000 Baht Doctoral (tuition and registration fee) - 1,484,000 Baht Master's (tuition and registration fee) - 848,000 Baht Student Dormitory Student Village (Single donor naming per building) - 500,000 Baht Standard Dorms per room (air-conditioned, water,heater, seperate toilet and furniture) - 200,000 Baht Amount of Donation THB (Baht) Please specify the purpose (required) I would like to pay by ChequeCredit CardBank Transfer Donation by Bank Transfer Bank Name: Siam Commercial Bank Public Company Limited Account Name: Asian Institute of Technology Saving A/C No.: 405-9995670 (Thai Baht and USD) Branch: Thammasart University Hospital Branch Address: 95 Moo 8, Klongnueng, Klong Luang, Pathumthani 12120, Thailand Swift Code: SICOTHBK Upload Pay-in slip (png, jpeg or jpg) (Please send the scanned copy of the pay-in slip to email@example.com) Cheque payable to ASIAN INSTITUTE OF TECHNOLOGY Upload Pay-in slip (png, jpeg or jpg) (Please send the scanned copy of the pay-in slip to firstname.lastname@example.org) Type of Credit Card VISAMASTER (Please note that Credit Card payment of more than 9,999,999 THB is not accepted by SBC payment. Please kindly transfer by Cheque or Bank Transfer.) Receipt to be issued to (required) Address Donor's name (required) For donors in Thailand, the donors can claim the donated amount as tax expense, as AIT is registered as No. 86 Non-profit organization with the Ministry of Finance.