Leukodystrophy Australia Recurring Credit Card Donation Form

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Payment Method

Credit Card (Visa, Mastercard, Amex) Cheque made out to Leukodystrophy Australia Direct Debit BSB: 193-879 Acc No: 457864204
Donation Amount
Donation Frequency
Thank you for your planned donation by Direct Deposit or Cheque. This process requires you to either post a cheque, or complete your donation via your own online banking.

Direct Deposit details:

Bank of Melbourne
Australian Leukodystrophy Support Group Inc
BSB: 193 879
A/C: 457864204
Please enter your name in the Reference field.

Cheque:

Payee: Australian Leukodystrophy Support Group Inc

Mailed to:

Leukodystrophy Australia
P O Box 2550,
Mount Waverley
VICTORIA 3149
AUSTRALIA

Please select frequency preference and adjust/set the recurring amount you wish to pay

Weekly Donation ( AUD for each week )

Fortnightly Donation ( AUD for each two weeks )

Monthly Donation ( AUD for each month )

Quarterly Donation ( AUD for each three months )

Annual Donation ( AUD for each year )

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To cancel a recurring donation, please contact us by email or phone and we will handle this offline.
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