Outback Futures Fundraise Form

Permission to Fundraise

First Name*

Last Name*

Email*

Mobile

Are you contacting us on behalf of an organisation, group, or club?*

Yes No

Why are you raising funds for Outback Futures? *
Total amount you expect to raise:*
How will you be raising the funds? (e.g. event, bake sale, challenge, etc.): *
Name of your fundraiser event:*
How will you collect funds? (e.g., online, cash, etc.):*
State or territory where your fundraiser will be held:*

What is your post code?*
Address of your fundraiser event venue (if your event is online, just type online):*

Fundraiser Start Date:*

Fundraiser End Date:*

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I hereby declare that all information provided to Outback Futures in this application is true and correct. I have read the Fundraising Terms of Agreement and agree to abide by all conditions contained within the guidelines. I understand that Outback Futures has the right to withdraw my approval to fundraise if I am in breach of any of the Fundraising Terms of Agreement.*

Permission to Fundraise

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