SOS Children's Villages Australia (SA) Inc.

Please fax this donation to:
SOS Children's Villages Australia (SA) Inc.
Fax 08 8232 9955

OR Post to

SOS Children's Villages Australia (SA) Inc.
78 Hutt Street,
Adelaide
SA 5000

Please make me ( your name ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . I would like to Remember a child in my Will with a special bequest.

Please make me ( your name ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . a member at a cost of
$ . . . . . . . . . . . . . . . per month

Please make me ( your name )..........................................................a member. I would like to make a single donation of $ . . . . . . . . . . . . . . .

Name:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Address:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

P/Code:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Email address:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Credit Card Visa ( ) / Mastercard ( ) / Bankcard ( ) Card No. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

In the name of. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Expiring on . . . . . . . . . . . . /. . . . . . . . . . . .