Bequest Form

Austcare has changed its name to ActionAid Australia For more information please visit the ActionAid website www.actionaid.org.au

Please choose the option below that applies:
Please contact me to discuss Austcare's activities and/or making a gift to Austcare in my will I have remembered Austcare in my will. I would like to be included as an Austcare Companion I have made a bequest to Austcare in my will. I would like my bequest to remain anonymous.
Please include any details in the box below regarding your current bequest
Title *	Select Mr Mrs Ms Miss Dr
Firstname *
Surname *
Street Address *
Address line 2
Suburb *
State *	Select ACT QLD NSW NT SA TAS VIC WA Overseas
Postcode *
Country *
Home Phone
Work Phone
Mobile
Email Address *
How did you hear about Austcare?	Select Friend TV advertisement News report Internet search engine Link from another website Met an Austcare representative Current Supporter
Preferred method of contact:	Mail Email Phone
I would like to receive regular updates by:	Mail Email