Print and Post Form
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Please print and post this coupon (and donation, if applicable) to:
Community Relations Department, Angliss Hospital
39 Albert Street, Upper Ferntree Gully 3156
or
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Email your donation details or enquiries to:
donations@boxhill.org.au
Mr/Mrs/Miss/Ms
Address
Postcode
Day time phone
Email
My cheque/money order is enclosed.
Please make cheques payable to Angliss Hospital.
Please debit the amount indicated above to my:
Bankcard
Mastercard
Visa
Account No.
Name on Credit Card (print)
Signature
Expiry Date
/
A receipt will be sent promptly.
Becoming a volunteer
How I can include Angliss Hospital in my Will
Making an in-kind donation
Sponsorship of hospital event
How my group can fundraise for you
Community Relations Department, Angliss Hospital
39 Albert Street, Upper Ferntree Gully 3156
Telephone: 9764 6106
Fax: 9759 1800
