Aussie Muscle Car Run 2016

Make a general donation to the Leukaemia Foundation

Note: You are NOT sponsoring anyone.

The Leukaemia Foundation is authorised by the Australian Tax Office as a deductible gift recipient. All donations over $2.00 are tax deductible.

* means we need this information

Put the receipt in my personal name
OR Put the receipt in the organisation's name

* First Name:
* Last Name:

* Organisation:

Your contact Information


	Home Work

Enter address manually
* Company Name:
* Address:

* Suburb:
* Country:
* * * State:
* Postcode:
Phone Number:	( )
Mobile:	( )
* Email:

Allow the Leukaemia Foundation to contact me about other events by email.

* Info about fundraising events such as Light the Night

Yes

* News of the Leukaemia Foundation's work and how the money helps

Yes

* Info about making donations to help families facing blood cancer

Yes

* Info from like-minded organisations that may be of interest

Yes

Payment Information

$28 can provide an information pack to help families prepare for the challenges ahead

$52 can provide personal support to someone in hospital during weekly visits

$80 can give a regional family a place to stay throughout treatment in the city, for one night

$120 can fund a scholarship to support a major blood cancer research project, for a day

Other amount

* Processing Date:

* Number of Installments:

installments

* Card Type:

* Card Number:

* Name:

* Expiry:

Security Check

We have implemented an extra step in order to prevent Credit Card fraud. Unfortunately, some people use automated programs to test whether fraudulently obtained credit cards are valid. To counteract this practice we ask that you answer the question below.