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Donations to ACCESS will be used to help raise public awareness on infertility and other reproductive health issues and to educate and support infertile people.  If you would prefer to discuss this further, please contact Sandra Dill, the CEO of ACCESS either via phone on +61 2 9737 0158 or email 

And your donation to ACCESS (over $2.00) is now tax-deductible.

 

If you are happy to now make a donation, please print this form, complete and forward with either credit card details, postal order or cheque to:

ACCESS Australia
Box 3605
Rhodes Waterside
Rhodes NSW 2138
Australia

Alternatively, print this form, complete and fax with credit card details to +61 2 9737 0245.  If you would prefer to submit your credit card details online, then please click here. 

 

Please accept my contribution of AUD$..................
(Please make all donations in Australian dollars.  For a currency converter, please click here.)

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Unless you indicate otherwise, we will acknowledge your donation in the next issue of our newsletter.
 I’d like to acknowledge the following person/s:

 

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If you’d like your donation to be in honour of a family, doctor, nurse, therapist, child, or volunteer please complete and we will acknowledge them in our next newsletter.

Please provide your details if you would like an official receipt or acknowledgement (please click here to read our privacy statement)

 

Contact name....................................................................................

 

Address.............................................................................................

 

Address.............................................................................................

 

Suburb/town......................................................................................

 

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Postcode/zipcode................................................................................

 

Country.............................................................................................

 

Telephone......................................................................................

 

Email address..............................................................................

 

Donation payment details

 

I enclose a cheque/money order for AUD$............  payable to ACCESS

 

OR

 

Please charge my credit card

  Bankcard   Master Card   Visa

 

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Expiry date   ________/_________

 

Name on card......................................................................................

 

Signature (essential)............................................................................

 

 

 

   

 
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