<body>

Pay online: Fitra (3.5 Kg of Dates)

Online Donations Page «

Quantity
Unit PriceRs. 2,900.95

(for one person)



Customer Information (All fields are required)

Title
First Name« Please enter your
name as it appears
on your Debit/Credit Card.
Middle Initial
Last Name
Phone
Email
Street Address« Please enter your
Debit/Credit Card billing address
City
State
Zip
Country