Thank you for your generous support.

Please accept my donation of:

Contact details:

DIRECT BANK DEPOSIT

Email: fundraising@specialolympics.com.au | Phone: 1300 225 762Post: Building 1, Level 3, 3 Richardson Place, North Ryde NSW 2113

$20

My donation is:

A personal donation

On behalf of company, group or association:

In support of:

In celebration of:

In memory of:

For a fundraising event (event name):

$50 $100 $500 other $

Email

I’d prefer to be contacted by

Name (Mr/Mrs/Miss/Ms/Other)

Address

Phone number: ( ) Email

I’ve attached a copy of my bank receipt – I made a direct deposit to:

Bank: Westpac BSB: 032-078

Account name: Special Olympics Australia Account Number: 507297

The deposit was made on / / Reference

Thank you for your donation. Your generosity will help us provide year-round sports training and athletic competition in a variety of

Olympic-type sports for children and adults with intellectual disabilities.

CREDIT CARD

OR

I would like to make a credit card donation. We will call you!To ensure your personal details are protected, we don't accept credit card details on this form.Please complete this form and send it to us and we'll be in touch. Otherwise, please call us on 1300 225 762 and speak to our friendly Fundraising Manager.

Please send a tax receipt to me I do NOT require a tax receipt for this donation

All gifts over $2 are tax deductible. Receipts are issued for all donations unless you tell us you don’t need one.

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