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>> Donation form

*** Print out this page, fill out the form and send it to Dr. Robert Lundy at the following address or fax number)

FAX: +61 (2) 9313 6346

Postal Address:
International House Ltd.
UNSW, Sydney, USW 2052
Australia


>> International House Scholarship Fund Contribution

Donations to the Scholarship Fund are tax deductible in Australia and the U.S.A.
In making this donation I understand that this is a gift to the UNSW International House Ltd. to assist in the establishment of International House Scholarships, and that neither I nor International House are entering into a contractual obligation.

> Your details

Name: Mr /Mrs /Ms /Dr /Prof
Company name:

Address:


Telephone (W):
Telephone (H):
Facsimile:
Mobile:
E-mail:

> Payment Method

Please charge my: Visa / Mastercard No:

Name on card:

Expiry date:

Signature:

or:

I enclose an AUD $ cheque or bank draft to "International House Ltd." (ABN 21000476933)

> Donation Acknowledgement

Please indicate how you would like your name to appear on the International House Honour Roll, publications or Scholarship Plaque, so that we may acknowledge your gift correctly: