Anglican Chaplaincy Tasmania Donation

Name  
Address  


Phone  
E-mail  
Donation Amount  
Method of Payment  
    Visa
    Mastercard
    Other

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Expiry Date  
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Please print this form, fill it out and post it to:

GPO Box 748
HOBART TAS 7001

phone 6223 8811
fax 6223 8968

Cheques should be made payable to:

Anglican Health & Welfare (ACT)