Award Ambassador Commitment Form
Contact 1
First Name
Surname
If applying as at Joint Ambassador (i.e. with your partner), please select the checkbox below:
Joint Ambassador
Contact 2
First Name
Surname
Address details
Street Address
City
State
Please select...
Australian Capital Territory
New South Wales
Northern Territory
Queensland
South Australia
Tasmania
Victoria
Western Australia
Postal Code
Contact details
Contact 1
Mobile
Email
Contact 2
Mobile
Email
Donation options
I would like to become an Ambassador of
The Duke of Edinburgh’s International Award - Australia
.
I propose to make my financial donation of $25,000:
As a lump sum of $25,000
In 5 annual installments of $5,000.
Other (please specify)
I propose to make my donation via:
Bank transfer
Cheque
EFTPOS (+2% surcharge)
Invoice
Please log into your internet banking, enter the details below, and use your name as the transaction "Reference".
Account Name:
The Friends of The Duke of Edinburgh's Award
BSB:
032-002
Account #:
484009
Bank:
Westpac
ABN:
85 020 371 716
Please make cheques payable to
The Friends of the Duke of Edinburgh's Award in Australia
.
We will contact you shortly to arrange payment over the phone.
We will send an invoice to your nominated email address shortly.
Note:
All Donations over $2 to The Friends of The Duke of Edinburgh’s Award are tax deductible.
You selected "Other (please specify)". Please provide details for how you would like to make your financial donation of $25,000.
Communications
Would you like to occasionally receive information from
The Duke of Edinburgh’s International Award – Australia
, including the Annual Report and any other brochures and information updates?
Yes
No
Contact Information