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To return to the ZIC site please click here. |
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Zimbabwe Information Centre Inc |
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Black Farmworkers Food Aid Program Financial Appeal |
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Please pay on the following form and return to ZIC Inc, PO Box K824, HAYMARKET NSW 1240, or fax back the credit card details to 02 9211 1407 ZIMBABWE BLACK FARMWORKERS FOOD AID PROGRAM FINANCIAL APPEAL Name: _____________________________________________________________ Address: ___________________________________________________________ ______________________________________________ P/Code ______________ Ph: __________________________________ Fax: _________________________ Email: _____________________________________________________________ [ ] I enclose $_________ by cheque / money order (payable to ZIC Inc) or please debit my credit card for $ ____________ for the Black Farmworkers Food Aid Program Appeal [ ] Bankcard [ ] Mastercard [ ] Visa [ ] American Express Card No: ______________ ______________ ______________ _____________ Expiry Date: _____ / _____ Name on card: __________________ Signature: ___________________________ Return to: ZIC, PO Box K824, HAYMARKET NSW 1240, or fax back the credit card details to 02 9211 1407 January 2002 If you have any questions please call the ZIC on (02) 9211 4164. To return to the ZIC site please click here. |