Please select the time frame for your fundraiser:
ongoing with commission payments made on a quarterly basis
6 week term only
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*Organisation / Group Name:
(This is the 'Organisation or Group Name' that will appear on your advertising flyer when created)

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*Organisation / Group Address:

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*Suburb / Town:

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*State: Please Select Victoria New South Wales Queensland Northern Territory South Australia Western Australia Tasmania           *Postcode:
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*Your Full Name:

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*Email Address:

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*Email Address Confirmation:

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*Contact Phone Number:

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Fax Number:

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*Are you registered for GST? Yes   No
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Organisation / Group ABN:


*Your preferred method of receiving commission payment/s? Cheque   Direct Deposit

If you selected payment via 'Cheque' above, please enter the 'Account Name' :

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BSB: (Direct Deposit)

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Banking Account Number: (Direct Deposit)

* = Required
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Please simply 'contact us' if any details change & require updating in the future.
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Your BSB and Account Number are required in order for us to successfully make your commission payments if 'direct deposit' selected.  If you do not have these details just now, please ensure that you provide them at a later date.

If your preferred method of payment is via cheque, please note there is a $5.00 fee per cheque to cover money order expenses.  This will be deducted from commission earned.