Rape Wise - Are You Rape Wise?

An informed child, is an empowered child

ParenTeen foundation/educator forum renewal and donation form

(More information regarding this section can be found in the December ParenTeen Newsletter)

Yes our family would like to renew our family membership for 2012/2013 @ R 100.00

Name and surname:
Mobile:
Tel:
Fax:
E-Mail:
We would like your monthly newsletters to include information regarding:
Donor form
Our family would like to assist Rape Wise by becoming a donor status family
Please tick one of the following:
Silver family status – R 150.00
Gold family status - R 250.00
Platinum family status - R 500.00
Or other R
Topics you would like to see in future newsletters?

Please use your name/organisation as reference on all banking transactions, fax completed form and payment to: parenteenfoundation@rapewise.co.za or 086 696 7807

Contact details: 083 3308535 for more details

Payment to be made via EFT to the following account:

Bank: ABSA

Account Name: Rape Wise

Account number: 4064976342

Branch code: 632005

An informed child, is an empowered child