Donation (cheque or money order) advice slip

 

DATE ____/____/20___

 

________________________    ___________________,  

(Surname)                                                                   (Given Name)                                 

 

 

________________________________,       ______________,   _______.

(Address)                                                                                                (Town/Suburb)                  (Postcode)

 

I would like to make a donation of $                            to ozED - Australian Ectodermal Dysplasia Support Group.

 

I understand that a receipt will be forwarded to me once the cheque/money order has been cleared by the bank.

 

I would/would not like to go onto the ozED email list.

 

(Email Address ________________________________________________)

 

I would like to go onto the ozED sponsors list (for people or organisations sponsoring projects or programs). 

 

Please contact me on ph (___)___________________ to arrange this.

 

 

___________________________

(Signature)

 

OFFICE USE ONLY

 

Date received _____/_____/20____                                                 Invoice number ____________________

 

Date receipt sent _____/_____/20____                                           Banked _____/_____/20____

 

Email update added ____/_____/20____                                        Website updated _____/_____/20____

 

 

DO NOT SEND CASH IN THE MAIL