Donation Form
Alison Hunter Memorial Foundation
ABN 98 085 075 305 | CFN 17014
Alison Hunter Memorial Foundation Medical Research Trust
ABN 27 103 523 800 | CFN 17078
Gifts/Donations of $2 or more are tax deductable.
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I
enclose the following, in Australian dollars, and made payable to either (please tick the appropriate boxes): |
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Alison Hunter Memorial Foundation
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Alison Hunter Memorial Foundation Research Trust
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Cheque |
Bank
Cheque |
Postal
Order |
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or
| Please charge my credit card as indicated | |
Amount: $ |
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Visa ( ) Mastercard ( ) |
Expiry Date: |
Card Number: |
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Signature: |
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Name: |
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Address: |
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Telephone: |
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| E-mail: |
Alison Hunter Memorial Foundation
PO Box 6132 North Sydney 2059 Australia
Phone/Fax +61 2 9958 6285
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