Donation Form

Australian Privacy Foundation Inc.
ABN 38 904 502 598

DONATION

We regret that facilities for on-line payment are not yet available.

Electronic Option:

• make a direct deposit to the APF bank account at Bendigo Bank, BSB 633 000 A/c No. 126 879 162 (preferably including brief text, such as 'Donation to APF'); and
• to send us details, copy-and-paste the whole of this web-page into an email, fill it in, and send the email to the APF Secretary.

Manual Option:

• send a cheque to P.O. Box 3348, Belconnen ACT 2617; and
• to send us details, print this form, fill it in, and enclose it with your cheque.

For the Foundation's Privacy Statement, see below*

To: The Secretary, Australian Privacy Foundation Inc.

I wish to make the following Donation: (Please Tick as Appropriate)

Donation to the work of the Australian Privacy Foundation:

O Amount $ ............................

Please list any specific campaign(s), issues(s) or proposals you are supporting:

...........................................................................................................................................

If you wish the APF to record your details, please fill in the following details:

Name of Donor:

...........................................................................................................................................

If Donor is an organisation, name of Contact Person and title of their position:

...........................................................................................................................................

Postal Address: .............................................................................................................

...........................................................................................................................................

Email address (optional): ....................................................

Contact telephone number(s) (optional): .................................................................

I am paying as follows:

• I enclose a cheque in favour of Australian Privacy Foundation for the relevant fee indicated            O
• I have made a direct deposit to Bendigo Bank, BSB 633 000 A/c No. 126 879 162 (and provided my surname with it to ensure that it is credited to the right person)           O

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Signature: ......................................................................... Date.................................

Rules of Incorporation. See the Foundation's Rules of Incorporation.

Privacy Statement. Personal information is collected for the purpose of administering the affairs of the Australian Privacy Foundation and communicating with members. It is handled in accordance with the National Privacy Principles. For further details see the Foundation's Privacy Policy.

OFFICE USE ONLY

Donation approved: [Date] ........................................

Donation received: [Amount} ........................................

Method of Payment: Cheque ? / Cash ? / Direct ?

Monies banked: [Date] ........................................

Member notified: [Date] ........................................

APF thanks its site-sponsor:

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Last Amended: 10 August 2010 by Roger Clarke - Site Last Verified: 11 January 2009
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