Printable donation form

Queensland Greens - Donations Form

Make a donation by printing this page, fill in the details and post with your cheque to:

Queensland Greens

PO Box 661

Albion BC  QLD 4010

or fax to:

FAX - (07) 3112 4337

Donations up to $1500 are tax deductible.

Name:

Residential Address:

Suburb/City: Postcode:

Email:

Telephone number(s):

Fax:

____ Yes I/we want to support the Queensland Greens

____ I/we enclose a donation of ( circle ):
 

$200    $100    $60     $40   $20   $10      Other $ ..............

____ I/we enclose a cheque/postal order for $ ............ payable to the Queensland Greens

____ Please debit my Bankcard/Mastercard/Visa ( delete as appropriate )

Cardholder's name:

Card number:

for $ .........
 

Expiry Date:                 /

Cardholder's signature:.................................................................................

____ Please tick if you do not wish to receive any further mailings from the Queensland Greens.

Disclosure

To uphold public transparency of the Party's sources of funding, the names of donors and amounts donated during the previous twelve months are disclosed on this website if the total of their respective donations equal $1,500 or more. This donor list is updated quarterly. The first $1,500 contributed during a financial year to a political party in Australia, including membership fees, is tax deductible.

In making this donation you are confirming that:

• you accept that your name and the total amount of your donations during the last twelve months will be included on our public donor list should the donations accepted by the Party from you during this period total $1,500 or more, and
• you have every reason to believe that your donation will not give rise to public criticism of the Party's integrity and that our acceptance of the donation will not be contrary to the Party's internal donations policy.

Australian law requires all donations to a political party totalling $10,000 or more in a financial year to be declared by both the donor and the recipient. If you are required to disclose your donation to the Australian Electoral Commission the Australian Greens will forward you the disclosure form by post to the address provided.