General Research Donation

A one off payment. For individuals, practices or organisations who want to support chiropractic research. No minimum commitment.

Please use the form below to make a single one-off donation to the Centre for Chiropractic Research.

Your details

Name(Required)

First Last

Company/Practice Name

Would you like correspondence relating to your support to be addressed to you personally or your practice/company?(Required)

Me personally

My practice/company

Address

Street Address Address Line 2 City ZIP / Postal Code Country

Contact details

Email(Required)

Telephone - Business

Telephone - Mobile

Donation

Donation(Required)

Donation amount (New Zealand Dollars)

Payment method

Credit Card (you will be directed to our secure payment gateway upon submitting this form)

Internet Banking (you will receive bank details and payment instructions upon submitting this form)

Tax receipt

I require a tax credit for the New Zealand Internal Revenue Department or a general receipt

Communication

Email updates

Please DO NOT send me email updates from the Centre for Chiropractic Research.

Please DO NOT send me email updates from the New Zealand College of Chiropractic.

We like to keep our supporters updated about the research we do and what is happening at the Centre and the College. If you would like to OPT OUT of receiving emails from us please indicate this below.

Additional comments (optional)