RHH Research Foundation Workplace Giving Program Pledge Form

Title *

First Name *

Surname *

Job Title *

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Employee Number *

Department/Division/Section *

Phone Number *

Mobile *

Email *

Mailing Address *

Please deduct from my pay, effective from *

Day

Month

Year

the following amount each pay period * $

My payroll regular donation is to be forwarded to the RHH Research Foundation, untill it is cancelled by me in writing.

do not want your information to be provided to third parties fundraising on behalf of the RHH Research Foundation *

I do not want my information to be provided to third parties fundraising on behalf of the RHH Research Foundation.

Please note that as a supporter or donor to the RHH Research Foundation, your personal information will be collected for the purposes you gave it to us and in order to advise you of news, events and fundraising activities relevant to the RHH Research Foundation. Your personal information may be disclosed to relevant third parties contracted by the RHH Research Foundation for events and fundraising activities, or as required by law. Please tick the box if you do not want your information to be provided to third parties fundraising on behalf of the RHH Research Foundation

For more information please contact the RHH Research Foundation on:

Phone: e: (03) 6166 8088
Email: research@rhhresearchfoundation.org

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RHH Research Foundation Workplace Giving Program Pledge Form