If you would like to give a one of gift / sponsorship or become a partner, please circle the amount you wish to give, fill in the following information and post your cheque, or email to:
Australian Heart Ministries 
PO Box 440 WOLLONGONG  2520  NSW  AUSTRALIA
Ph/Fax: 61-2-4272 9100  Email:  support@ausheart.com.au

1.  Major Sponsor	-	I would like more information	-	YES  

2.  TV Show		-	I would like more information	-	YES 
Naming Rights Sponsorship

3.  Gold Sponsor		-	$12,000 pa or $1,000 per month-	YES	

4.  Silver Sponsor		-	$6,000 pa or $500 per month	-	YES	

5.  Bronze Sponsor	-	$3,000 pa or $250 per month	-	YES

6.  Strategic Mission Supporter$1,200 pa or $100 per month	-	YES

7.  Supporter			$240 pa or $20 per month	-	YES

8.  I would like to pray for Australian Heart Ministries
Please put me on your mailing list					-	YES

For Direct Deposits – our details are as follows:
Australian Heart Ministries Inc9875235
Westpac Wollongong A/C 180234
Please inform us of Direct Deposits so that we can receipt and thank you!

Please complete the following to make your payment: 
Yes, I would like to become a partner/sponsor on a monthly basis.  
Please deduct $_________ monthly/ or one of amount  $____________     
 ٱ Visa     ٱ Mastercard     ٱ Bankcard
Card No  ٱٱٱٱ   ٱٱٱٱ    ٱٱٱٱ   ٱٱٱٱ   
Expiry Date  ٱٱ / ٱٱ  Signature________________________
Name on Card ____________________________________________
Mailing Address 
Name____________________________________________________
Address__________________________________________________
City________________________State__________Postcode________
Phone_______________________Email________________________