Enquiry Form

	Muscular Dystrophy 111 Boundary Road North Melbourne, VIC 3051
Telephone: (03) 9320 9555 - Fax: (03) 9320 9595 Contact Person: Linda Lowe Email: cards@mda.org.au
Muscular Dystrophy Association, providing Hope to the one in 1,000 men, women and children affected by this devastating, muscle destroying disorder.

To complete your enquiry, you must:

a.) Complete this form
b.) Click the 'Send To Charity' button
c.) To print this document,
click here.

*Card

*Quantity

*First name

*Last name

Company

*Phone number

Fax number

*Email Address

Address

Suburb


State	Postcode

*May we contact you
next year when our
new range is available?

Yes No

*Please enter the letters
and/or numbers you see

(Generate new)

Please note:
Our member charity will contact you to thank you for your enquiry and to discuss any overprinting requirements. For any special requirements, please do not hesitate to contact the Charity direct.

*Fields are required

Level 23, Tower 1 520 Oxford Street, Bondi Junction NSW 2022
Telephone: 02 9779 1533 Facsimile: 02 8305 0555
If you have any queries, please contact us on info@charitygreetingcards.com.au

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Enquiry Form

Muscular Dystrophy

To complete your enquiry, you must:

a.) Complete this formb.) Click the 'Send To Charity' buttonc.) To print this document, click here.

click here.

a.) Complete this form
b.) Click the 'Send To Charity' button
c.) To print this document,
click here.