捐款表格 Donation Form如果您已經通過線上或線下向我們進行了捐款,可通過填寫此表格告知我們。或打印此表格、填寫並郵寄給我們 If you have already donated to us online or offline, you can let us know by filling out this form. Or you could print this form, fill it out and mail it to us.Please enable JavaScript in your browser to complete this form.再次感謝您的慷慨解囊與支持。Once again, thank you for your generous and compassionate support.姓名/機構 Name/Organisation: Mr/Mrs/Miss/Ms/Mx *FirstLast地址 Address: *Address Line 1Address Line 2CityState / Province / RegionPostal Code— Select country —AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Kingdom of)EthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Republic of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountry聯絡電話 Contact Number: 電郵 Email: (如有/If any)捐款金額 Donation Amount: *我的捐款是為了紀念 My donation is in honour (or memory) of :* Optional 選填捐款方法 Methods ** 劃線支票抬頭: Crossed cheque payable to “Chinese Cancer and Chronic Illness Society of Victoria” ** 直接存入維省新生會賬戶: Direct transfer to Chinese Cancer and Chronic Illness Society of Victoria Bank Account*** 現金捐款 Cash Donation 備註: 1. 捐款2元或以上將獲發減稅收據; 2. 收集的資料必會保密處理,並只供我們與您聯絡之用。 Remarks: 1. A tax-deductible receipt will be issued to donations of $2 or above. 2. Data collected will be treated strictly confidential and for communication with you only** 已存入以下哪個 維省新生會賬戶 Directly transferred to which CCCIS account shown below? *Westpac Banking Corporation, BSB No: 033-000; Account No: 864 256; Account Name: Chinese Cancer and Chronic Illness Society of VictoriaOverseas Donations: National Australia Bank, BSB No: 083-004; Account No: 97-302-1932; Account Name: Chinese Cancer and Chronic Illness Society of Victoria Incorporation Business Everyday AC*** 現金捐款註明 Cash Donation Specification: *如有匯款證明需上傳 / Bank Transfer Receipt to upload if any Click or drag files to this area to upload. You can upload up to 2 files. 您希望通過以下哪種方式接受您的捐款減稅收據?How would you prefer us to send you the tax-deductible receipt? *郵寄 By Post (僅限於澳洲境內 only available within Australia)電郵 By Email (請確認您已填寫了正確的郵箱地址 please ensure you have completed the correct email address above)前來領取 Collect in person提交 Submit