Bairo Pite Hospital – We need your support to continue to provide care Bairo Pite Hospital sees support for the inpatient beds and the nurses as the first priorities amongst many. Sponsor a Bed There are 55 inpatient beds at Bairo Pite Hospital. The total cost of care for each patient in each bed is approximately $10 per day ($300 per month). This covers medication, medical supplies, medical staff, pathology, utilities, food and laundry. Please tick one of the following boxes to sponsor a bed at Bairo Pite Hospital for: □ 1 month - $ 300.00 □ 6 months - $1,800.00 □ in one donation □ in monthly instalments of $300.00/month □ 12 months - $3,600.00 □ in one donation □ in monthly instalments of $300.00/month □ Ongoing support in monthly instalments of $300/month □ Ongoing contribution to the cost of a bed of $_________ monthly Part of Sponsor a Bed Syndicate named:_____________________ (The name can be finalised at a later date) For 6 months or more support the bed can be given a name by you (eg the Jones Family bed) and this name will be placed on the wall above the bed for the duration of your support of that bed. We will contact you to discuss naming the bed. Sponsor a Nurse Our Nurses work 12 hour shifts. They are paid almost exactly the same amount each month as the cost of sponsoring a bed-$300 a month. They usually have 5 or 6 children at home and are often the sole source of income for their family. They are dedicated and have some superb skills. They are the ones who insert the IV cannulae and set up the IV drips. They are the ones who administer all the medications and who ensure that the patients get the care that they need. Please tick one of the following boxes to sponsor a nurse at Bairo Pite Hospital for: □ 1 month - $ 300.00 □ 6 months - $1,800.00 □ in one donation □ in monthly instalments of $300.00/month □ 12 months - $3,600.00 □ in one donation □ in monthly instalments of $300.00/month □ Ongoing support in monthly instalments of $300/month □ Ongoing contribution to the wage of a nurse of $_________ monthly Part of Sponsor a Nurse Syndicate named:____________________ (The name can be finalised at a later date.) If you sponsor a nurse for 3 months or longer then we will ensure that you and you sponsored nurse can correspond so that you have a very first hand connection with the care at the Hospital. Or a donation can be made that is not part of the Sponsor a Bed or Sponsor a Nurse program to support any of the other major medical services delivered by the Hospital I would like to make a donation to assist in the work of Bairo Pite Hospital of: $1,000 $500 $100 $50 $25 Other $ □ $____________ once □ $___________ monthly until further notice Please continue on to the next page to see how to make a donation The Bairo Pite Hospital (BPH) - Our Partnership With AFAP “Bairo Pite Hospital is a community partner of AFAP. AFAP and Bairo Pite Hospital work in collaboration with local communities to deliver development initiatives in Timor-Leste. AFAP is committed to supporting effective development programs overseas and closely monitors all the work we undertake including initiatives undertaken as part of the Community Partner Program. Bairo Pite Hospital does not have DGR status in its own right and relies on AFAP’s DGR status endorsed by the ATO, therefore any donations to support the activities of Bairo Pite Hospital must be made through AFAP in order to be tax deductible. Whilst AFAP will endeavour to comply with the wishes of the donor, AFAP retains a discretion at all times whether or not to distribute donated property(money or otherwise) in accordance with the preference expressed by the donor. AFAP allows donated property (money or otherwise) to be used only for benevolent activities. For more information on how to donate, please contact AFAP or Bairo Pite Hospital.” Thank you for your donation, your support is greatly appreciated. All donations of $2 or more are gratefully received and fully tax deductible. Details (to appear on your tax receipt): First name: _____________ Surname: ___________________ Business / Trust / Foundation name (if applicable): ___________________________________________ Address: ________________________________________________________________ Telephone: ________________ Mobile: __________________ Email: ____________Fax: ____________ Credit Card Details: Credit card type (please circle): Visa Mastercard Credit Card Number Expiry Date: _____ CCV number (Last 3 digits on back panel): _______ Name on Credit Card:_________________ Donations by cheque: Cheques should be made out to AFAP (Bairo Pite Hospital) Donations can be made by telephone: 1800 007 308 Donations can be made through the AFAP website: www.afap.org For a website donation: Click on donate, then click on Donate to our Partners, select AFAP Partners which automatically brings up a drop down menu with Bairo Pite Hospital on it Donations can be made by faxing or posting: Fax: 02 9436 4637 Post: PO Box 12, Crows Nest, NSW, 1585 There is much more to the Bairo Pite story In addition to the 55 in-patient beds, BPH runs an extensive out-patient consulting service which sees between 200 and 300 people a day, a busy ante natal care unit, a labour ward where over 100 babies per month are delivered, an outpatient supervised treatment of tuberculosis clinic, HIV diagnosis, counselling and treatment, daily mobile clinics to outlying communities, a dental clinic and the training of community birth attendants and village health workers. Would you like to talk with us about other ways to support BPH (for example a corporate sponsorship or corporate assistance relationship, pro bono services, a personal time commitment, in kind donations/support, getting involved personally in the work of BPH)? □Yes What is the best way to contact you? _______________________________________