"Together we can make a difference to preserve and improve human life"  

Name:…………………………..
Address:………………………..
…………………………………
…………………………………
Stae: …………… Postcode:…...
Phone:………………………….
E-mail:…………………………

· By cheque or money order to
Charity Quest
P.O Box: 2289, Dandenong NTH, Vic – 3175.

By Credit Card:
Name of Card Holder:………………………………

Master card Bankcard Visa

Card No:………...…………………………………………
Expiry Date: ………………….
Signture:……………….. Date: ……………………..