Buy a Patch of Land, Save the Taiwan Pink Dolphins

Buy a Patch of Land, Save a Pink Dolphin (Second Phase)
「全民認股守護白海豚」國民信託認股意願表（第二階段）

Pledge Form (No payment is necessary at this point.)

Please fill out this pledge form and email to Changhua Environmental Protection Union 7626609@gmail.com, or fax to 04-7769516.

* One share is one square meter. Each share is NT$119.

ARC or Passport No. ______________________________

Name __________________________________________

Contact Telephone ________________________________

Address _________________________________________________________

Email ___________________________________________________________

Pledge Amount (You may pledge up to 1000 shares in each area.)
Area 1. Eurasian Curlew No. of shares _____
Area 2. Black-faced Spoonbill No. of shares _____
Area 3. Little Egret No. of shares _____
Area 4. Saunders's Gull No. of shares _____
Area 5. Little Tern No. of shares _____
Area 6. Black-winged Stilt No. of shares _____
Area 7. Sentinel Crab No. of shares _____
Area 8. Soldier crab No. of shares _____
Area 9. Bristle worms No. of shares _____
Area. 10 Croaker No. of shares _____
Total No. of shares _____NT$______


How did you hear about Buy a Patch of Land, Save a Pink Dolphin?

________________________________________________

Anything else you would like to let us know?

_________________________________________________

Thank you for your support!