Logo

To contact us:

Phone:  51277166  

1800 452 452 

Fax: 51272880

Postal Address:                 

PO Box 34 

Yarragon  3823

E-mail: hwABI@bigpond.net.au

Headway Gippsland Inc. is a registered charitable organisation. All donations over $2.00 are tax deductible under the Income Tax Assessment Act 1997.

We will receipt all donations.

 

Name/Organisation …………………………………………………………………………………Address:

………………………………………………………

………………………….                Post Code:………….

I / We wish to donate $.......................................

 

Send to:            Headway Gippsland Inc.

                          PO Box 34

                          Yarragon   Vic  3823  

Your Donation will help local people with an ABI

  Headway Gippsland Inc.

Caring for people with acquired brain injury and their families.

Membership & Donation Forms

(Can be printed and sent.)

Name/Organisation ………………………………………………………………………………………………………………………………………………………………………

Address:……………………………………………………………………………………………………………………………………….Post Code:…………………..

 

I am (please tick relevant boxes)              Type of Membership

             o an individual with ABI                  o $10.00 Individual

             o a family member                            o  $15.00 Family

    o An interested individual 

             o    An Organisation                             o $20.00 Organisation

Members must be over 18 years of age

Send to:            Headway Gippsland Inc.

                          PO Box 34

                          Yarragon   Vic  3823                            

Membership Application