PO Box 16
THE GAP Q 4061
Phone: 07 3300 0906
Fax: 07 3300 0906
A donation to the Kidney Support Network in memory of a loved one is a precious gift. It will help in the care and support of kidney patients and their families throughout Queensland.
When you wish to make your memorial gift, please fill in the information below. Your donation will be acknowledged with a receipt. Please note all donations over $2 are tax deductible.
We will inform the bereaved family of your memorial donation, keeping the amount confidential.
Name:
Address:
Phone:
Amount of Donation:
Please notify the bereaved family
Name:
Address:
Direct Deposit
Account Name: Kidney Support Network Inc. General Account
BSB: 064000
Account Number: 00051383
Please use ‘(last name) donation’ as reference
Credit Card Payment
Credit Card Number:
Name:
Expiry Date:
Please send to PO Box 16, The Gap QLD 4061.
Thank you again for your memorial gift, and for supporting Kidney Support Network.