Regular Monthly Donation

I would like to make a regular monthly gift. (The minimum we can accept for monthly donations is $10 per month.)  

On the 1st day of the month or nearest business day, HFA will debit  your specficied amount from your credit card. This method of making your donation will continue until we are advised in writing by yourself or your representative to cease making the transactions. If you could please advise if there are any changes with your card number or expiry date. HFA will send you an annual receipt at the end of the financial year.

Any questions please contact Natashia Coco ncoco@haemophilia.org.au

I have authorised Haemophilia Foundation Australia to deduct the above nominated amount from my credit card upon receipt of this form and then on a monthly basis. This authorisation is to remain valid until revoked by either myself or Haemophilia Foundation Australia.