Yes! I would like to support KULCHA
and make a tax deductible donation!

Amount:
$200
$2,000
other amount
OR
an annual gift
$5,000
$10,000
$

$
Payment Method: Electronic Funds Transfer
Please complete the form
and make the funds transfer in the usual way to the account below.
Please use your Family Name as a reference
BSB: 306 048
Account: 5617004

Credit Card
You can give us your credit card details on a secure link on the next page.
Contact Details:
Title
Family Name
Given Names
Organisation
Address
Town/
Suburb
State postcode
Email
Phone (H) Phone (W)
FAX
Acknowledgement: I would like my gift to be anonymous.
I would like to be acknowledged in the KULCHA annual report
and on the KULCHA website.
Background:
(optional)
Date of Birth
(DD/MM/YYYY)
Cultural
Background
Languages
Spoken
Occupation
Interests
Music Theatre Dance
Visual Arts Film
Other

Verification:


Please enter the five digit verification code above
(five strong digits only)
Thank you for your support of KULCHA Multicultural Arts of Western Australia!



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