Keio Academy of New York—Payment Information

If you have questions, please feel free to contact us.

Donor's Information

Description Cherry Blossom Reception
Student Name First Name: Last Name:
 ex: Taro  Keio   (If you are parents of Keio's student, please specify.)
Graduate Year
 ex: 2012   (If you are a Keio NY Alumni member.)
Current Employer  ex: Keio Academy of New York
Anonymous(匿名)   Anonymous Donation
Donation *

Additional Contribution is always welcome. Non-deductible portion $25.

 * required item

Billing Information

Name * First Name: Last Name:
ex: Taro  Keio
E-Mail *  ex:
Street Address *  ex: 2-15-45 Mita
City *  ex: Minato-ku
State *  ex: Tokyo
Postcode *  ex: 108-8345
Country *  ex: JAPAN
Phone Number *  ex: 03-1111-1111
Fax Number  ex: 03-1111-1112

 * required item
• 情報は全て半角英文字で入力してください。

Donation Refund Policy
We are grateful for your donation and support of Keio Academy of New York. Donations are normally nonrefundable, but if you have made an error in making your donation or change your mind about contributing to our organization, please contact us at within 15 days from the date of your donation. Refunds are credited to the same credit card you used to make your donation.