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Organisation Contact Details

Appeal Name:	Volunteers helping people with disabilities in South Australia
Organisation Name:	Technical Aid to the Disabled (SA) Inc
Address:	PO Box 540 MODBURY SA 5092
Fax:	08 8369 1051
Phone:	08 8261 2922

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	Suburb	State	Postcode
Phone:	Home	Work
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Email:

Payment Details — Please Print Clearly

I would like to donate		$	to Technical Aid to the Disabled (SA) Inc
	Enclosed is my cheque / money order
	Please charge my credit card

Credit Card Details

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Expiry Date:	/	CVV:
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Date of Donation:

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