One time Assembly Donation Form

Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number
Please enter a valid phone number.
Tell us about yourself / Congregation / Other
One Time Donation*

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AUDDonation capped at 9999$ for larger donations contact the office enquiries@nat.uca.org.au
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