Thank you for your gift this Christmas.

Thank you for deciding to make a generous donation as a gift to Diabetes SA this Christmas, we are very grateful. Completing your donation will take just a few minutes and a receipt will be sent to you via email (remember: all donations over $2 are tax deductible).

1. How much do you wish to give this Christmas?

	$310.00 AUD	will send a child to kids' camp
	$120.00 AUD	allows a person with diabetes to attend our Living Healthy 6 week course
	$75.00 AUD	will give a newly diagnosed person with diabetes free access to education session
	$50.00 AUD	allows a child aged between 2-12 years with diabetes and parent to attend a support group activity
	$35.00 AUD	provides education to teachers in schools
	$15.00 AUD	will provide awareness and prevention packs to school, business and community organisations

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 Diabetes SA

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