DONATIONS

If you wish to contribute towards towards our organisation please fill in the form below and enclose it with your donation:

I enclose a cheque/postal order of R ..............

Name:....................................................................................................

Address..................................................................................................

.................................................................................................................

.................................................................................................................

code............................. Tel ..............................................

Date:...........................................................

Authority for donation by Credit card to Build Adult Learning Co-operative (BALCO)

Please debit  my ....................... MasterCard .....................Visacard

Year/Month/Day.................................................................................

In the amount of .....................................................

Card Number .........................................................

Expiry Date YYMM ................................................

Signature ...............................................................

Date ........................................................................