In Memoriam Gift Form

Alternatively, make an In Memoriam Gift by cheque, money order or credit card by mail. Please click here to download and print the In Memoriam Gift form. Post the completed form to:

Heart Research Centre
PO Box 2137
The Royal Melbourne Hospital Vic 3050

A receipt will be forwarded promptly.

If you prefer simply call us on 03 9326 8544.

Every donation of $2 and over is tax deductible.

In Memoriam Gift

When you make an In Memoriam Gift, the bereaved will receive a letter expressing our sympathy and advising them of the name of the person who has made a memorial gift to the Heart Research Centre. We do not mention to the bereaved the amount of the donation sent to us, unless otherwise specified. A letter of thanks, which includes a receipt, will be forwarded to the donor.

It is simple and secure to make an In Memoriam donation online by Visa or Mastercard by completing the form below.

First Name *
Last Name *
Company Name
Address Line 1 *
Address Line 2
Address Line 3
Town *
State/County/Province
Postcode *
Country *
Telephone
E-Mail Address *
Confirm E-Mail Address *
My donation is made in memory of:
I would like to give: $
Donor Number (if known):
Please send a receipt for my donation to me at the address above:
Please send a letter acknowledging my donation to:
Name:
Address:
Suburb:
State:
Postcode:
Please type in the letters you see:
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Protecting your privacy: Your personal information will remain confidential as we do not share our information with others. To read our privacy policy in full please click here.

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