Community Partner Contact and Payment Details

Thank you for your ongoing support as a Community Partner. We appreciate you taking the time to update your details. If you have any questions about completing this form, please contact our Fundraising team on (03) 9421 7600 or email: fundraising@jss.org.au.

Fundraising Data Migration

Contact details

Name(Required)

Prefix First Last Suffix

Address details

Address(Required)

Street Address Address Line 2 Suburb State Post Code Country

Email(Required)

Phone(Required)

Donation details

Donation amount(Required)

Card Type(Required)

Cardholder name(Required)

Credit/Debit card number(Required)

Expiry date(Required)

Would you like to receive communications electronically only?(Required)

Yes, please contact me via email only

No, please continue to send hard copies also

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