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To help the Heart Foundation, print the form below and send to:
|
Heart Foundation, 411 King St, West Melbourne, VIC 3003 |
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Mr/Mrs/Ms/Miss |
Surname |
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Address |
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Postcode |
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| Phone number: (H) | (W) |
My gift to the Heart Foundation is $_______________________
I enclose my cheque/money order or
Please charge my credit card
Please send me more information about remembering the Heart Foundation
in my will
Credit card details
Mastercard
Visa
Amex
Bankcard ___________(Expiry date)
| Number: |__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__| |
|
Signature |
| Cardholder's name |
