lead group membership & donation form

If you think that our service is worth maintaining, show your support by:

Making a donation to the Lead Education and Abatement Fund (LEAF). Donations over $2 are tax deductible. Please donate at http://www.www.leadsafeworld.com/donations for secure donations or see the suggested wording there for making a bequest, and/or
Becoming a member of The LEAD Group Incorporated, by filling in the membership form, and/or
Writing a letter to your state and federal Ministers for the Environment, and to your Ministers for Health, asking them to ensure continued funding of the Global Lead Advice and Support Service Australia (GLASS).

Your support is very much appreciated. The current appeal aims to gather enough donations to cover the costs of my attendance at the 6th Global Partnership Meeting (6GPM) of the United Nations Environment Programme (UNEP) Partnership for Cleaner Fuels and Vehicles (PCFV) which will be held during the last week of January 2008. Among other things to be discussed at 6GPM will be the completion of the PCFV's global campaign to phase out leaded gasoline (leaded petrol) for road use.

Elizabeth O�Brien
President, The LEAD Group Inc
Partner, UNEP Partnership for Cleaner Fuels and Vehicles (PCFV)

The community cost of each lead poisoned child (ie for each 10 �g/dL rise in lead in blood) is $10,280 in remedial education costs, health costs and lost earning potential. When compared to the call cost of LASA�s FY 1999-2000 service, if only one of 246 calls results in preventing one child from exceeding the Australian goal, the service is cost effective.

SUBSCRIPTION FORM for LEAD Group Membership & DONATION FORM for LEAF (Lead Education and Abatement Fund)

Print the form and fax or mail your subscription or donation (see below). Donations over $2 are tax deductible.
[Printable version]

Purchase Memberships at http://www.leadsafeworld.com/shop/

The purpose of the Lead Education and Abatement Fund (L.E.A.F.) is to support the environmental objects of The LEAD Group Incorporated, that is to protect the environment from lead.

Please accept my membership application and/or donation:

$10.00 annual membership (non-corporate rate)

� $132.00 annual membership (corporate rate)

PAYMENT DETAILS:

Please find enclosed my cheque / money order for $________
payable to: "The LEAD Group" being for membership

Please find enclosed my cheque / money order for $________
payable to: "LEAF" (Lead Education and Abatement Fund) being for a donation

� Please charge the amount of $____________
to my � Visa Card � Master Card (tick one) payable to:
"The LEAD Group" being for membership

� Please charge the amount of $____________
to my � Visa Card � Master Card (tick one) payable to:
"LEAF" (Lead Education and Abatement Fund) being for a donation

Please Print & Mail form & payment to:

The LEAD Group Inc.
PO Box 161
Summer Hill NSW 2130 Australia

OR fax the form to:
+61 2 9716 9005

OR phone us with your credit card details on:

+61 2 9716 0966

Freecal - 1800 626 086 (Australia only)

Name on Card:_________________________________________________

Signature ________________________________________

CARD NO. |__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__| Expiry date: _____ / _____

Card verification code: |__|__|__| look on the back of the card for a 3 digit code on the signature strip. It will be either after the full customer account number or after the last 4 digits of the customer account number

CONTACT DETAILS:

Name or Company Name (for corporate subscriptions):

____________________________________________________________________________

Address:

____________________________________________________________________________

Phone:___________________________ Fax/email:______________________________

Purchase Memberships at http://www.leadsafeworld.com/shop/

PDF of this file [Printable version]