Donation Receipt - Arohanui Hospice, New Zealand

Donations over $5 are eligible for Income Tax Exemption. If you require acknowledgement and/or a receipt please complete and submit this form

Title:
First Name:
Surname:
Address:
Post Code:
Reason for donation: General, or In Memory of:
Date donated:
Amount donated ($):
Please do not retain personal information on file:
The Privacy Act 1993 requires us to advise you that we keep the names, addresses and telephone number of our supporters on file to help us with our fundraising. If you do not wish us to store this information, please advise us. If you wish to check the details on your file, you are welcome to inquire.