Christ Church, Claremont
National Trust Heritage Appeal

I would like to support the appeal by donating to the
National Trust of Australia (WA) Christ Church Claremont Heritage Appeal.
Simply complete this form on the screen, print it, sign it and return it to:
Christ Church Claremont
PO Box 121 CLAREMONT WA 6910
Please accept my donation of (donations of
$2 and over are tax deductible in Australia)
$25     $50     $75    $100     $500
other (please specify) $
 
I wish to make a regular donation of:


Every
$10     $25    $50    $75     $100
other (please specify) $
month      quarter      year
other period (please specify)
 
Personal Details (items marked * are required information)
Title: State*
First name*: Post code*
Last name*: Telephone No:
Address* E-mail address:
City*:    
 
Payment details:
  I would like to establish a Direct Debit from my bank account (see Direct Debit form below)
  I attach a cheque/money order, payable to: The National Trust (WA) Christ Church Claremont Heritage Appeal
  Please charge my credit card:
      Card number:     Exp date:
 Name on card:       Signature:
 
Direct Debit (items marked * are required information):
(This service is only available for recurring donations such as monthly ones and cannot be used for one-off donation)
I/we (name) request you, until further notice, to debit my/our account any authorised amounts which the Anglican Community Fund may debit or charge me/us through the Direct Entry system.
Bank name*: Account name*:
Branch Address: Signature(s)*  
BSB*: - Date*:
Account number* Name of the Parish to
receive my/our gift:
Christ Church Claremont
Heritage Appeal
In memoriam: Your donation can be made in memory of a loved one and recorded in our memorial gift book on display in the Parish Office
Name of person to be remembered: