Thank you for choosing to support ICU. We are grateful for your generosity.

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For U.S. , Canadian, and Mexican residents, please send your contribution through the Japan ICU Foundation.

Please fill in the form below and click the "Confirm Information" button when you have finished.

Your Donation
Donation Type		Single Donation Recurring Donation (Annual) Recurring Donation (Monthly)
Amount		Please Select 10,000 yen 20,000 yen 50,000 yen Other (Please specify amount)  yen
Areas your donation will support		Please select ICU Peace Bell Scholarship ICU Torch Relay Scholarship Promotion of Organ Music and Organ Music Education Conserving Natural Environment on Campus Syrian Scholars Initiative (SSI) Improvement of Facilities Improvement of Facilities (D-kan) Improvement of Facilities (New Honkan) Improvement of Facilities (Honkan) Taizanso Conservation and Restoration Fund Overall Support for ICU Support for Hachiro Yuasa Memorial Museum For Students Affected by Natural Disatsers

Your Personal Information
Name
Name in KANJI
Birthday		1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 / 01 02 03 04 05 06 07 08 09 10 11 12 / 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Example: 1970/12/31
Current Address		(Please type using half-width characters.)
Phone Number		(Numbers Only)
Email Address
Email Address (Confirmation)
Would you like your donation to be anonymous?		Yes
Your affiliation with ICU (1)		Please select up to two categories of affiliation. --Select-- Alum Current student Relative of current student / alum Faculty/staff Trustee/auditor/councilor ICU Church member Rotarian Other --Select--
Your affiliation with ICU (2)		--Select-- Alum Current student Relative of current student / alum Faculty/staff Trustee/auditor/councilor ICU Church member Rotarian Other --Select--

Please select your preferred payment method

Credit Card
  Automatic Withdrawal

Credit Card Information
Notes		The date on the receipt for your donation will be the day ICU receives the payment from the credit card company, so please note that it may take 2-3 months for us to issue a receipt after you make your donation via credit card.
Credit Card Number		(Numbers Only) You can use the following credit cards
Expiry Date		01 02 03 04 05 06 07 08 09 10 11 12 / 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033 2034 2035 2036 2037 2038 2039 2040
Card Holder Name
CVV (Security Code)		(Numbers Only)

Request a Transaction Form (No Transaction Fee)
We will send you a form for the transfer of funds. If you send your donation via Japan Post Bank, Mizuho Bank, or MUFG Bank, Ltd., no transaction fee will be charged.

ATM/Internet Banking
If you wish to use ATM or Internet banking, please send your donation to the following ICU accounts at Japan Post Bank, Mizuho Bank or MUFG Bank, Ltd.

Automatic Withdrawal
You can contribute regularly from your bank account, starting from 10,000 yen per year and 3,000 yen per month（※）. We will send you a form to transfer the funds. ※Receipts for monthly donations will be issued annually for the entire cumulative sum.

As stated under the bylaws of International Christian University's Privacy Policy, any personal information we receive will be used only for the purpose of fundraising and for contact from ICU. All information submitted on this form is transmitted securely via SSL certificate.

Please read and check the box below: Payment Date and Issue of Receipts