Thank you for your generous gift.

SIDS and Kids Western Australia rely heavily on the generosity of the community to help us save babies' lives and heal families impacted by the death of a child.

1. How much do you wish to donate

	$25.00 AUD	Can provide a lifesaving resource pack to new parents
	$44.00 AUD	can provide one hour of phone counseling
	$84.00 AUD	can provide an individual counseling session for parents
	$550.00 AUD	Can provide a life saving education to a rural region in WA
	$125.00 AUD	Can provide a bereaved family with a home visit by a counsellor

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:

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Contact

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3. Further communications

Keep in touch.

Please check the box if you wish to receive more info from SIDS and Kids Western Australia

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

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Everyday Hero deducts a small service fee and passes all donations on to your nominated charity and arranges receipts.