new tear off slip here - royal western australian historical society · 2018. 5. 30. · tear off...

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………………………………………………………………...…………………

I/we will be attending the Night of Bling and Bubbles on

Saturday 7 July at 5:00pm

I enclose payment for $___________

I wish to further support the Museum and Library Building

Project with a donation of $___________

Please tick box if a Tax receipt is required

Please return to the Office, RWAHS, 49 Broadway,Nedlands, WA 6009. Phone: 9386 3841 Email:admin@histwest.org.au

Payment is accepted by Cheque, Mastercard, Visa or by direct

deposit to the RWAHS Bank Account:

BSB: 016 484 Account No: 2478 76223

Please leave your name when paying directly.

in name of ___________________________________________

Signature: ___________________________________________

Contact: ___________________________________________

Phone H: _______________Mob: _______________________

(3 digit no. on back of card)

Card Number:

Expiry Date: CVC: /

Tear off slip here

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