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SLHD Donation Form
Donation
Donation Information
Amounts less than $2 are not tax deductible
$1000
$500
$250
$100
$50
$25
*
Amount $
Donations of $250 and above entitles you to a free Elimination Handbook as a Thank You gift.
Send me the free Elimination Diet Handbook
Send gift to the same address
*
Please select the facility/service
your donation is for
Please select an option
ANZAC Research Institute
Balmain Hospital
Canterbury Hospital
Community Health
Concord Repatriation General Hospital
Mental Health
Royal Prince Alfred Hospital
SLHD Health Centres
Sydney Dental Hospital
Sydney Local Health District
*
Please direct my donation to
Please select an option
Type of gift
Personal Donation
In-Celebration
In-Memory
Workplace Giving
Bequest
Authorised Fundraiser
Other
Corporate Gift
Other Gift Type
Would you like to leave a message?
Donor Information
Title
A/Prof
Dr
Master
Miss
Mr
Mrs
Ms
Mx
Other
Prof
First name
Surname
Country
Australia
Other
Country name
Address
Address
Suburb
Post Code
State
ACT
NSW
NT
QLD
SA
TAS
VIC
WA
State
Phone
*
Email
*
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No
Required!
When you press
"Donate Now"
you will be taken to a secure area where you can safely enter your credit card information.
After payment please click 'Finish' to return to our website for more options.