Please print this form and send it along wiith your donation to:

Hikari Institute
98-211 Pali Momi Street, Suite 640
Aiea, Hawaii 96701 USA

Enclosed please find a donation in the amount of $________________________.

Please provide the following information for our records (and so that we can send you a receipt):

Name: ________________________________________________________________

Address: ______________________________________________________________

City: ___________________________ State: _______________ Zip: ______________

Telephone: _____________________ Fax: _______________________

E-mail: ______________________________

Mahalo for your support!

The spirit of Karate is the Aloha spirit

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Copyright © Hikari Institute, a Hawaii non-profit corporation and federally
tax exempt organization under IRC 501(c)(3). All rights reserved.