ABN 78 002 677 581                                         Authority to Fundraise CFN 13448

I believe in your cause and wish to make a real difference by donating:

AUD USD NZD GBP EUR

35

50

100

500

1000

Or as follows:

A$ US$ NZ$ £ €

Method of Payment

American Express

Visa

MasterCard

Credit Card No

Exp. date:

Security Code*

* American Express: four digits above the card number. * Other cards: last three digits on signature strip.

I authorise Aboriginal Children's Advancement Society to operate on these instructions

Name

Please repeat surname

Mr Mrs Miss Ms Dr Clr Fr Sr Br Hon. Sir Lord Lady

You may address me  as:

Address:

City:

State/Prov:

Zip/Post. code:

Country:

* Email address must be entered

Phone:

email:

Cheque

Send with this printed form.

Please make cheques payable to Aboriginal Children's Advancement Society Address all correspondence to: The General Secretary Aboriginal Children's Advancement Society PO Box 277 SUTHERLAND NSW 1499 AUSTRALIA

Donations are tax deductible :

Please keep me informed on the work of Aboriginal Children's Advancement Society

Please send a gift certificate to

Name

Email