Broken
Bay
Institute
The Broken Bay Institute Scholarship in Theology
University Newcastle Donation Form
University of of Newcastle Donation Form
Donor/Organisation name: ___________________________________________________________
Address: __________________________________________________________________________
State: _________________________________ Postcode: _______________________________________
Telephone: ___________________________ Email: _____________________________________________________
Donation to: Broken Bay Institute Scholarship in Theology__________ Amount: $ _________________
Privacy
The University of Newcastle complies with the Privacy and Personal Information Protection Act 1998. All donations are publicly
acknowledged including but not limited to publications, marketing material and annual reports. If you wish to remain anonymous please
contact the University of Newcastle - Foundation Team to state your wish. The payment information provided on this form will be used by
Treasury Operations to process your payment. The provision of this information is voluntary. Your personal information will be securely
stored.
Tax Deductibility
Donations to the University of Newcastle may be eligible deductions for income tax purposes under the Income Tax Assessment Act 1997.
I/we note the advice of the Australian Taxation Office regarding the characteristics of tax deductible donations i.e. that they are made
voluntarily ant that they do not provide any material benefit to the donor. I/we understand that
the University of Newcastle has an obligation to respect my/our wishes in relation to the purpose of the donation,
the donation, once made, will be under the University of Newcastle’s sole direction and control,
receipts will be issued according to the individual or company name as indicated above,
contact details may be used to update the University of Newcastle’s records.
University of Newcastle ABN: 15 736 576 735
Signature of donor: _____________________________________________ Date: _______________________
Thank you!
Donation options: Please send your donation with this form (credit card details, cheque/money order only).
Only donations made in Australian Dollars can be accepted.
Please return this form and your donation to the below address. Alternatively fax or email your donation.
The Cashiers SC 306 F +61 2 4921 7418
The University of Newcastle E finserv-revenue@newcastle.edu.au
CALLAGHAN NSW 2303 Australia
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I would like to make my donation above via:
Credit card (Visa / Mastercard) I authorise my credit card to be debited Amount: _____________
Card No: _ _ _ _ / _ _ _ _ / _ _ _ _ / _ _ _ _ Expiry Date: _ _ / _ _
Cardholder’s name: _______________________________Cardholder’s signature: _______________________
Cardholder’s daytime phone no: ________________________ Date: __________________________________
Cheque/Money order (Made payable to the University of Newcastle)
Cashier Use Only
G/L: 10.50282.4502 GST Code: F Narration 1: BBI Scholarship in Theology Note: send receipt and top portion
Narration 2: Type name of donor/organisation of form to UON Foundation.