Scholarship Fund Donation

Please complete the following details

Your Details

First Name  

Last Name  

Contact Number  

Email Address  

Address  

Address line 2  

State None NSW NT QLD SA TAS VIC WA  

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Are you an Old Collegian? No Yes  

Gift Details

Name / Company for Tax Deductible Receipt  

Please nominate your donation $5,000.00 $2,500.00 $1,000.00 $500.00 Other Amount  

If other, please specify  

I wish for my gift to remain anonymous None No Yes  

I wish my donation go to Any Scholarship Global Citizen Indigenous Leonardian