Donate to Candidate's campaign for Shepparton! |

Choose amount

Greens candidate for Shepparton

Other

Contribution Amount *

$10

$30

$50

$100

$250

other

Total Amount

I want to contribute this amount every month

Personal details

Your Contact Information

First Name *

Last Name *

Street Address *

Address Line 2

Suburb/Town *

Country

State *

Postcode *

Email *

Phone *

Other Information

Please add your residential address details below if different to the address above, plus your phone contact details and any comments you would like to add regarding your contribution.

Address Line 1

Address Line 2

Suburb/Town

State

Postcode

Home Phone

Mobile Phone

Work Phone

Your Comments (Optional)

Payment details

Credit Card

Card Type

Card Number *

Security Code *

Expiration Date *

Summary

After the state election, your regular gift will continue to generously contribute to the Victorian Greens’ ongoing work.

Please note that, under Victoria's funding and disclosure laws, contributions through this page are for a State electoral purpose.

You should be aware of the tax implications and disclosure obligations that result from your contributions to the Australian Greens Victoria.

If you have questions regarding the extent of your personal contributions, you can contact State Office on 03 9912 2992‬.

I am an Australian Citizen or Permanent Resident