| Registered under the Charitable
Fundraising Act 1991 (NSW). Registered number: CFN 11071. Print out this form and use it to make a donation to Communicare Sydney. (CTRL-P) The Hon Treasurer Yes! Id like to make a donation towards the work of Communicare Sydney. NAME Mr./Mrs./Ms/Miss/Rev/Dr............................................................................................. ORGANISATION(If appropriate)......................................................................................... ADDRESS ........................................................................................................................ .................................................................POSTCODE...................................................... TELEPHONE NUMBER.................................................................................... FACSIMILE NUMBER ..................................................................................... E MAIL ADDRESS........................................................................................... I have attached my cheque/money order for [ ] $35.00 [ ] $50.00 [ ] $100.00 [ ] $200.00 [ ] Other ............. Alternatively, please charge my: [ ] Mastercard [ ] Visa [ ] Bankcard Number: [ ][ ][ ][ ] [ ][ ][ ][ ] [ ][ ][ ][ ] [ ][ ][ ][ ] Name on Card ........................................................ Exp. Date................................ Signature ............................................................................... [ ] Please send me details about leaving Communicare Sydney something in my Will
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