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]