Donation Type*

Donation Amount*

Gifts $2 and over are tax deductible.

Donation Amount (per month)*

Gifts $2 and over are tax deductible.

Other amount*

Other amount per month*

First Name*

Last Name*

Organisation

Email*

Address*

Street Address Suburb State Post Code Country

Contact Phone*

Payment Method*

Credit Card*

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

Account Name

BSB

Account Number

Comments

Authorisation*

I authorise The Freedom Project to deduct my nominated Credit Card or Bank Account according to the details on this form.

All payments are in AUD (Australian Dollars). Any changes in this agreement requested by you or by us requires reasonable notice be given.

Terms & Conditions*

Would you like to receive updates from The Freedom Project?*

How would you like to receive tax-deductible receipts?*

Receipts will be sent to the email and name provided above.

What prompted you to give today?*

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Name

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