CURTIN UNIVERSITY DONATION FORM

CURTIN
UNIVERSITY DONATION FORM
By giving to Curtin, you’re not just helping the university - you’re helping the community.
Your contribution helps to improve our education and research, which plays a priceless role in
improving the standard of living for our local community and people around the globe.
1. DONOR DETAILS
Your tax reciept will be issued in the following name. Please print clearly.
Title: Dr
Address: First Name: Last Name:
Suburb: Country:
State: Postcode: Phone:
Mobile:
Email: 2. GIFT DETAILS
I would like to make a:
Single gift of:
$
Recurring gift of:
$
Payable Monthly (1st of each month)
Annually on the 1st of (month)
I would like to remain anonymous
Signature:
Curtin University is a trademark of Curtin University of Technology
Date:
“Education is the most
powerful weapon which you
can use to change the world.”
- Nelson Mandela
C A M B R I D G E D I C T I O N A RY O F
PSYCHOLOGY
CURTIN
UNIVERSITY
DONATION FORM
3. PAYMENT DETAILS
I wish to support (select one):
Please send me information on:
Wherever the need is greatest
How to include Curtin in my will
Student Scholarships Fund
Other ways of giving
Research and Innovation Fund
Postgraduate education
Other area of interest:
Other (specify):
Cheque (made payable to Curtin University)
Credit Card:
Visa
Mastercard
Name on card:
Amount:
Card number:
Expiry:
Cardholder signature:
Date:
4. PLEASE RETURN THIS FORM TO
Post:
Curtin Foundation
Curtin University
GPO Box U1987
Perth WA 6845
Curtin University is a trademark of Curtin University of Technology
Tel:
+61 8 9266 3113
$
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