Please update my contact details:

I would like to make a donation to support
____________________________________________________
Please make a tax deductible donation by completing this form and returning to the contact details listed below.
You can also give online at http://www.monash.edu.au/giving/
I would like to make a gift of:  $100
Personal details
 Ms
 Mr
 $250
 Mrs
 $500
 Miss
Organisation
 $1,000  $5,000  $________other
 Dr
Other………………………….
Position Title
Given Name(s)
Family Name
Preferred address
(for mailing of receipt)
Suburb
State
Phone
Mobile
Postcode
Email
Payment details
 Electronic Funds Transfer (EFT) (bank details overleaf)
 Cheque, made payable to ‘Monash University’ attached
 Visa
 MasterCard
 Amex
Card number
 Diners
Expiry:
/
Cardholder’s name
Signature
 I would like my gift to remain anonymous. I do not want my name listed in publications or honour rolls
OR
 I would like my donation to be individually recognised as:_____________________________________
Please send your completed donation form to:
Mail to:
Fax to:
Phone:
External Relations, Development and Alumni
Monash University
PO Box 197, Caulfield East VIC 3145
(03) 9903 4885 (confidential fax for credit card donations)
(03) 9903 1608 or Email: [email protected]
Donations over $2 are tax deductible for Australian tax payers
Privacy: Monash University is committed to protecting your privacy. Personal details are held and used strictly in
accordance with the Privacy and Data Protection Act 2014 (Vic).
Electronic Funds Transfers (EFT) Details
Beneficiary Name and Bank Account Number:
Beneficiary Name:
Monash University
Beneficiary Address:
710 Blackburn Road, Clayton
Victoria 3168
Australia
Bank Account Name:
Monash University General Account
Bank:
Westpac Banking Corporation
Bank Branch:
Campus Centre
Clayton Campus
Monash University Victoria 3800
Australia
Bank Branch Phone:
03 9905 3148
BSB Number:
033-289
Bank Account Number:
630759
Swift Code / Bank Transit No:
WPACAU2S
IBAN:
033289630759
DUNS Number:
753252691
Send Remittance Advice To:
Address:
Monash University
External Relations, Development and Alumni
PO Box 197, Caulfield East, 3145, Victoria
Fax:
03 9903 4885
Phone:
03 9903 1608
Email:
[email protected]