:: Minoru Hokari Memorial Scholarship Funds ::
The Australian National University (ANU): Minoru Hokari Memorial Scholarship Fund



I would like to assist with the Minoru Hokari Memorial Scholarship Fund.

MY PERSONAL DETAILS

Name:

Address:

Telephone:
Facsimile:
Email:

MY GIFT AND PAYMENT DETAILS

Please accept my donation of $_____________ to The Australian National University in support of the Minoru Hokari Memorial Scholarship Fund

[  ] My cheque/money order made out to 'ANU - Minoru Hokari Memorial Scholarship Fund' is enclosed

[  ] Please deduct my donation from this credit card
[  ] Visa [  ] Mastercard [  ] Bankcard [  ] Amex

Card number: ____________________________ Expiry date: /

Cardholder name: (Please print)________________________

Cardholder signature: ________________________________ Date:

[  ] Please send me updates about the Scholarship and/or the work of the Australian Centre for Indigenous History

Please return this form to:
Director, Foundation and Alumni Relations
Block 1, Building 003
The Australian National University
Canberra ACT 0200
Australia

Tel:: (61)-2-6125-0462/7814
Fax: (61)-2-6125-9698
E-Mail: Endowment@anu.edu.au

RECEIPTS
Donations to The Australian National University are eligible for income tax deductibility in Australia. The University will automatically issue an official receipt to all donors who supply their name and postal address with their gift.

PRIVACY
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The primary purpose of information collected here is the processing and receipting of your donation. Secondary purposes may include the updating of your donation records and for future fundraising approaches.If you do not wish information provided here to be used for the secondary uses outlined above, please tick this box: 

Thank you.

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