DONATIONS

The Coastwatchers Association Inc. Environment Fund

Name of Donor : …………………………………………………...………………..………..

Address: ………………………………………………………………………...………….…

……………………………………………………………….… Post Code…….…………….

Amount of Donation: $……………………….

Signature: ……………………………………..

Date: …………………………………………..

Note: If the Donor is a Business or Corporation, please supply the Name and Title of the person authorised to sign this form

Name:……………………………………..

Title: ……………………………………...

Please make cheque / money order payable to:

The Coastwatchers Association Inc. Environment Fund

and send with this form to:

The Secretary
The Coastwatchers Association Inc.
P O Box 521
Batemans Bay NSW 2536