my gift to melba

1. my gift to melba Via Fax: 9736-2224 Via Email: melba@melbasupport.com.au Via Mail: PO Box 316, Mt Evelyn 3796 Via Phone: 9760-8200 On-line: www.ourcommunity.com.au/melbasupportservices I would like to support the following Melba Project: Communication Transport Community Connections I am interested in the following: Becoming a volunteer Receiving the Newsletter Sponsoring an issue of the Newsletter Making a regular pledge to Melba Becoming a Financial Member Receiving the Annual Report Making a bequest to Melba in my will In kind services e.g. electrical, building, painting etc. (Type of Service ______________________________) Your generosity is greatly appreciated All donations to Melba are tax deductible (DGR 900 282 405) Cheque / postal order $ $1,000 $500 $50 My Choice Periodical Pledge: Fortnightly Monthly 6 Monthly Yearly Please debit my credit card for the amount above Mastercard Visa Bankcard No. _______________________________________________ Expiry Date -- -- / -- -- Receipt Required Yes / No Signature: _________________________________________________________ Contact details: Name: ___________________________________ Address: ________________________________________________ Suburb: __________________________ Post Code: _____________ Phone: ____________________ Mobile: ____________________ Email: ____________________________________________________