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Gift amount:	$ 50.00 $ 100.00 $ 500.00 $ 1,000.00 $ 5,000.00 Other $     *
Designation:	The ANU Fund (University Priorities) CASS Equity Travel Grants CAP – Asia and the Pacific Travel Grant CBE Changing Futures Scholarship Natasha Linard Scholarship for Women in Eng & Tech Phillipa Weeks Scholarship in Law ANU Science, Health and Medicine Scholarship Fund
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If ANU staff, where in the University do you work?:	ANU College of Asia and the Pacific ANU College of Arts and Social Sciences ANU College of Business and Economics ANU College of Engineering and Computer Science ANU College of Health and Medicine ANU College of Law ANU College of Science ANU Central Division Other
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Title:	<Please select> Adjunct Associate Professor Adjunct Professor Admiral Air Chief Marshal Air Vice-Marshal Ambassador Archbishop Archdeacon Associate Professor Bishop Brigadier Brother Captain Colonel Commander Commissioner Commodore Constable Consul Corporal Councillor Dame Datin Dato' Datuk Dean Deputy Dean Deputy High Commissioner Deputy President Deputy Vice-Chancellor Dr Emerita Professor Emeritus Fellow Emeritus Professor Father General Governor H.E. Her Honour His Honour Judge Justice Lady Lama Lieutenant Lieutenant Army Lieutenant Colonel Lieutenant Commander Lieutenant General Lord Madam Major Major General Marshal Miss Mr Mrs Ms Mx Pastor Prince Princess Principal Private Professor Rabbi Rear Admiral Reverend Right Reverend Senator Senator the Honourable Sergeant Sir Sister Squadron Leader Sub Lieutenant The Honourable The Honourable Doctor The Honourable Justice The Honourable Professor The Honourable Sir The Reverend The Right Honourable Vice Admiral Vice-Chancellor Viscount Wing Commander	*
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