Thank you for buying a gift of love this Christmas

Our deepest thanks to you for helping us to meet those people that have 'fallen by the Wayside' this Christmas so that we can stand with them at their worst moment and see them through to better days. Completing your donation will take just a few minutes and a receipt, as well as gift certificate which can be passed on to your loved one, will be sent to you via e-mail.

1. Choose a gift of love

	$25.00 AUD	Heaps of Hospitality - Hate Hunger, Love Hospitality
	$50.00 AUD	Oodles of Understanding - Hate Ignorance, Love Understanding
	$100.00 AUD	Tons of Support - Hate Loneliness, Love Community
	$200.00 AUD	Loads of Love - Hate Homelessness, Love the Homeless

Specify amount:

(For example, to donate $100.00 AUD just type in 100 or $5.50 AUD type in 5.5. No symbols or words please.)

2. Donor Details

Your personal and contact details for our records.

I am donating as

an individual.

a company or organisation.

Company or Organisation Name:

Personal Details

Salutation:

First Name

Last Name

Contact

Email Address

Confirm Email

Phone

Address

Country

Street 1

Street 2

Suburb

State

Postal Code

3. Further communications

Keep in touch.

Please check the box if you wish to receive more info from The Wayside Chapel

I would Like Everyday Hero to send me a copy of the receipt at the end of the financial year.

4. Payment Method

How would you like to pay?

Pay with Credit Card Visa_37x23 Master_37x23

Cash or Cheque Bpay_23 Austpost_23