AIA Australia

I'm fundraising for...

We are fundraising for everyone who has been impacted by epilepsy.

All donations will be donated to the Epilepsy Foundation so that they can continue kicking goals in helping to support people living with epilepsy and their families.

Together, let's tell epilepsy to GET MUCKED!

Select amount to donate

$25

$50

$75

$100

Donate

All payments are secure & encrypted

Personal Donation Company Donation

First Name*

Last Name*

Email Address*

Mobile

Postal Address (enter manually)

UnitStreet Number

Street

Town/Suburb

Postcode

State

Country

I'm agree to opt in to communications from the Epilepsy Foundation via

Yes No

Leave a Message (Optional)

Name to appear on page (Optional)

I'd like to remain anonymous to the fundraiser

All payments are secure & encrypted

Credit Card

Name on Card *

Card Number *

Card Expiry *

CVV Number * Donation

Cover platform costs

I'd like to add a little extra to help cover fees.

All payments are secure & encrypted

AIA Australia

I'm fundraising for...

Please Help Me
Reach My Goal

Raised

$0

My Goal

$1,000

Select amount to donate

No one with epilepsy should go it alone.

Links

AIA Australia

I'm fundraising for...

Please Help MeReach My Goal

Raised

$0

My Goal

$1,000

Select amount to donate

No one with epilepsy should go it alone.

Links

Please Help Me
Reach My Goal