To: SPCK-AUSTRALIA and ACLS

Donation form

(Please complete this form, print this page and post it to us,
our address is a the bottem of this page)

(* Indicates required fields)

Personal Details

*Your email address
*First Name
*Last Name
Title (Mr Mrs Revd Other Ec)

Postal address

*Box number or street address
*City
*State
*Postcode
*Country

Please include any message you have below

Your Message

I would like the following:

Please add me/us to your mailing list
Please mail a Donation / Support Form
Please keep me up to date with Prayer requests

Please accept my donation.

Amount $
  Mastercard VISA BankCard
Card Number - - -
Expiry Month Year

SPCK-Australia Contact Details

Email: admin@spcka.org.au
Phone: 1300-13-SPCK (Local call in Australia)
Fax: 08-8364-4647
Post: Box 190 Rundle Mall Post Office, Adelaide South Australia 5000