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Support #QUTGivingDay

I would like to make my donation by: CREDIT CARD (please provide details below) CHEQUE / MONEY ORDER (enclosed – made payable to QUT)

I would like to give: $ My Challenge is:

I would like my gift to support (please select one of the below options):

Restoring the Great Barrier Reef

Budding Entrepreneurs Scholarship

Save Australian Wildlife

Learning Potential Fund

Indigenous Chair

Prostate Cancer Research

Other:

Credit Card Payments only

Visa Mastercard Amex EXPIRY DATE: /CARD TYPE:

CARD NUMBER

CARDHOLDER NAME:

CARDHOLDER SIGNATURE:

MONTHMONTH

Your Details MR MRS MS MISS DR PROF OTHER

FIRST NAME

SURNAME

ADDRESS

SUBURB STATE

COUNTRY POSTCODE

PHONE

EMAIL

Please return completed form by mail in an envelope (no stamp required) addressed to:

QUT Advancement Office Reply Paid 2434 Brisbane QLD 4001

For other enquiries please contact the Advancement Office on +61 07 3138 2147 or by email at giving@qut.edu.au.

CCV:

I have already included a gift in my Will to QUT.

I would like to be contacted regarding a gift to QUT in my Will.

Please do not acknowledge my gift in QUT publications.

I would like my gift to be: One-time only Recurring every month/quarter/year (circle)