The William Hill & Son Grand Organ Restoration Appeal I/We ............................................................. ..................................................................... Address .......................................................... ..........................Postcode..................... Telephone Private................................ Business ............................. I/We wish to make a donation towards the William Hill & Son Grand Organ Restoration Appeal I/We wish to donate $__________ My/Our cheque is enclosed I/We wish to donate $__________ over two financial years, this year's contribution is enclosed. (please tick the appropriate box) Payment by: Cheque Visa Mastercard Amount ...................................... Card number _ _ _ _ / _ _ _ _ / _ _ _ _ / _ _ _ _ Expiry date ........................................ Name on card ..................................... ................................................................ Signature ................................................................ Date To ensure Tax deductibility please make cheque payable to: Organ Historical Trust of Australia Send this form with your donation to: Organ Historical Trust of Australia Grand Organ Restoration Appeal PO Box 178 Blackwood, SA 5051 Receipts will be provided