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Thank you for making a donation to Disability Sport & Recreation. Completing your on line donation will only take a few moments and your receipt will be emailed to you upon completion.

All credit card transactions are secured using 128 Bit Secure Socket Layer (SSL) Encryption.

All transaction amounts are in Australian Dollars (AUD).

Delivery of your donation is instant.

DSR will refund donations within 28 days of the original transaction when requested to do so in writing.

A copy of the tax receipt is needed for the refund to be processed.

To request a refund, email fundraising@dsr.org.au or write to Refunds, Disability Sport and Recreation, PO Box 207 Abbotsford VIC 3065

Refunds will be credited to the credit card used for the original transaction.

All fields marked with * are required.

Donation Type
- - I want to donate to - - General Appeal Wheelchair Appeal Junior Disability Summer Camp Junior Disability Winter Camp
Donation Amount
	$500 $100 $50 $25 Other amount   Please specify amount $
Frequency:	- - Donation Frequency - - Only once Once a month Quarterly Annually
Contact Details
Donation Type	Personal Donation Company Donation
Title
First Name
Surname
Company Name (if company donation)
Address
City/Suburb
State/Territory	--State-- NSW QLD SA TAS VIC WA ACT NT Other
Postcode
Country	Australia New Zealand USA UK Other
Email
Phone
Mobile
How did you hear about us?	Internet Newsletter Direct Mail Fundraising Team Phone Appeal
Credit Card Details
Credit Card Type	- -Please Select- - VISA Mastercard American Express Diners Club
Credit Card Number
Name on Card
Expiry Date	January February March April May June July August September October November December   2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021
CCV	(What's this?)
	I would like to receive further information from Disability Sport & Recreation Please do not send me further information
Complete
	Please check that all of your details are correct and all required fields have been completed, then click on the “Submit now” button below to proceed. Thank you very much for your donation.