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Fax Gift Donation Form
Deaf Services Queensland
473 Annerley Road
PO Box 173
Annerley QLD 4103
Voice: 07 3892 8500
TTY: 07 3892 8501
Fax: 07 3392 8511
MY GIFT
Yes, I would like to make a donation of: ($AUD) $
donations over $2 are tax deductible
Card Type:
Visa Mastercard Bankcard Amex
Name on card:
Card Number:
Expiry:
MY DETAILS
Title: First Name: Middle Initial:
Last Name:
Company Name:
Address (1)
Address (2)
Address (3)
Suburb: Postcode: State:
Phone Number: Mobile Number:
Email:
Please Fax to Deaf Services Queensland: (07) 3391 8511
 
Thank you for helping to change lives of Deaf and hard of hearing people!