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Organisation Contact Details

Appeal Name:	Gay & Lesbian 'Switched On' Appeal
Organisation Name:	Gay & Lesbian Switchboard (Vic) Inc
Address:	PO Box 21291 Little Lonsdale Street MELBOURNE VIC 8001
Fax:
Phone:	03 9663 2474 [do

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Email:

Payment Details — Please Print Clearly

I would like to donate		$	to Gay & Lesbian Switchboard (Vic) Inc
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Credit Card Details

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Expiry Date:	/	CVV:
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Date of Donation:

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