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	Fax a Donation to the Good Friday Appeal


	Direct Fax Number all year round (03) 9292 2650 Direct Fax Number Good Friday (03) 9697 7964

I am proud to support the Royal Children's Hospital Good Friday Appeal.

I wish to donate the sum of $ ___________________

Name:

Street:

Town:

State:

Postcode:

My Credit Card Details:


	Bankcard


	Mastercard


	Visa


	Amount $:


	Cardholders Name:

Card No: _ _ _ _ : _ _ _ _ : _ _ _ _ : _ _ _ _

Expiry Date: / (month/year)

Your Phone No:

Signature:

Royal Children's Hospital Good Friday Appeal