Australian Cyclists Party Inc - Donation Form

Thank you for making a donation to the Australian Cyclists Party Inc.
If you would like to donate by EFT or cheque, please print and post this PDF Donation Form.
If you would like to donate using a credit card (via Paypal) please complete this online Donation Form.

I would like to make a donation of:

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Optional — regular giving:

I would like this donation to automatically repeat each month

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Must be in this format please: 28/04/1978 (As required by the Australian Electoral Commission).
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