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Thembalitsha Foundation

PO Box 1795, Somerset West, 7130, South Africa+27 (021) 852 3425fax: +27 (021) 852 3465

NPO No: 007-490  Reg No: 1997/003064/08​​ . Registered charity in South Africa, United Kingdom and USA​​

www.hope.org.za

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I hearby authorise the Thembalitsha Foundation to debit my account on behalf of Thembalitsha for the above amount and frequency. I understand that this will be processed through a debit order collection system. The authority of this debit order can be cancelled by giving the Thembalitsha Foundation 30 days notice in writing, sent by pre-paid or registered post or a signed fax. Please notify us immediately should any of your contact details change.

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