1. Online Order Form

    Billy G's Cookie Dough

  2. Organisation Information
  3. Organisation or School Name*
    Please enter the name of your school or organisation
  4. Organisation Type*
    Please select your group type
  5. Organisation or School Address*
    Please enter your organisation's or school's street address
  6. Address Line 2
    Please enter your organisation's or school's street address
  7. Suburb*
    Please enter your suburb
  8. State or Territory*
    Please select your state or territory
  9. Postcode*
    Please enter your postcode
  10. Co-Ordinator Details (must be at least 18 years old)
  11. First Name*
    Please enter the first name of the coordinator
  12. Last Name*
    Please enter the last name of the coordinator
  13. Position*
    Please enter the position of the coordinator
  14. Daytime Phone*
    Please enter the daytime phone number of the coordinator
  15. Evening Phone*
    Please enter the evening phone number of the coordinator
  16. Mobile Phone*
    Please enter the mobile phone number of the coordinator
  17. Facsimile
    Please enter the facsimile number of the coordinator
  18. Email Address*
    Please enter the email address of the coordinator
  19. Treasurer's Name*
    Please enter the name of the Treasurer
  20. Treasurer's Phone Number*
    Please enter the phone number of the Treasurer
  21. Fundraising Program Details
  22. Order Forms
  23. Address for mailing of order forms*
    Please enter the address for mailing of order forms
  24. Number of Students/Members*
    Invalid Input
  25. Date Order Forms Required*
    / / Please enter the date that order forms to be handed out to your students or members
  26. Fundraiser Start Date*
    / / Please enter the date that order forms and monies due back to you
  27. Fundraiser End Date*
    / / Please enter the date that order forms and monies due back to you
  28. Delivery date for Cookie Dough (please allow 14 days for delivery from the day that you order)*
    / / Please enter the date that you would like your Cookie Dough to be delivered
  29. Address for Cookie Dough Delivery*
    Please enter the address that you would like the Cookie Dough to be delivered to
  30. Last Step
  31. How did you hear about us?*
    Please select one option
  32. Would you like to join our mailing list?*
    Please select Yes or No
  33. Terms and Conditions of Sale
  34. Promo Code (if applicable)
    Please enter your promotional code
  35. I have read and accept the Terms & Conditions of Sale*
    Please accept our Terms & Conditions of Sale
  36. Invalid Input