Post or Fax your Donation

Thank you for your Donation

Please POST your donation to:-

Rock Community Care Inc.
PO Box 3922
South Brisbane B.C. 4101

Please FAX your donation to (07) 3844 1342

Please accept my gift of:     $____________________

Donation to:

[ ] Doorway of Hope Appeal
[ ] Disaster Relief
[ ] Christmas Appeal
[ ] Other (please specify)   ___________________

Please select your method of payment:

[ ]    Money order

[ ]    My cheque is enclosed marked 'Not Negotiable' and payable to 'Rock Community Care Inc. Gift Fund'

[ ]    Please debit my credit card:

Select [ ] Bankcard     [ ] Mastercard      [ ] Visa

Credit card Number:

_____ /_____ /_____ /_____

Name on credit card:

_____________________________

Expiry Date:

___ /___

Signed:________________________________

Surname:_______________________________

First name: _____________________________

Address: ______________________________

Suburb/Town:__________________________

State:_________________________________

Postcode: _____________________________

Telephone:
( ____ ) ______________________________

Fax:
( ____ ) ______________________________

Mobile:
  _____________________________________

Email:
  _____________________________________

Tick here for more information regarding:

          [ ]    Direct debit options for regular contributions
          [ ]    Remembering Rock Community Care Inc. in my Will
          [ ]    Free information booklets on making a Will

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Thank you for your kindness in supporting Rock Community Care Inc.

A receipt will be posted to you when your donation has been processed.

Any enquiries about donations, contact us on (07) 3844 5232 or via email at donations@rockcc.org.au

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