Donation form - Don`t Dis My Appearance

HELP BUTTERFLY
TAKE A STAND AGAINST
APPEARANCE BASED JUDGEMENT
AND BODY SHAMING
PA
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I N T YO
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P A I N T YO U R M I D D L E F I N G ER FO R M AY
dontdismyappearance.org.au
I want to take a stand against appearance based
judgement and make a donation to help the
Butterfly Foundation fight eating disorders.
I/We would like to give to Butterfly
Title:
First Name:
Surname:
Company Name:
Address:
Postcode
Phone:
Email:
Amount
$
My cheque/money order is enclosed
(made out to The Butterfly Foundation) OR
Please debit the above amount to my:
Mastercard
Visa
Card Number:
Cardholders Name
Expiry date
/
Signature
The Butterfly Foundation uses your name and address details to keep you better
informed of our activities and services. If you do not wish to receive further communications
from us or would like to be removed from our database, please call (03) 9822 1911.
Send to: The Butterfly Foundation
PO Box 7026, Glen Iris VIC 3146
Donate online: dontdismyappearance.org.au
Thank you
All donations over $2 are tax deductible. A receipt will
be sent to you promptly.
PO Box 7026, Glen Iris VIC 3146
P: 03 9822 1911 F: 03 9822 5776 E: [email protected]
www.thebutterflyfoundation.org.au ABN 42 102 193 582
TBF_MAY 2015