1. REGISTER FOR ONLINE FUNDRAISING FOR THE BILLY G’S COOKIE DOUGH FUNDRAISER

  2. Group Details
  3. Group Name*
    Please enter the name of your school or organisation
  4. Address*
    Please enter your organisation's or school's street address
  5. Suburb*
    Please enter your suburb
  6. State*
    Please select your state or territory
  7. Postcode*
    Please enter your postcode
  8. Phone*
    Please enter the daytime phone number of the coordinator
  9. Contact Details
  10. Name*
    Please enter the first name of the coordinator
  11. Position*
    Please enter the position of the coordinator
  12. Email Address*
    Please enter the email address of the coordinator
  13. Mobile Number*
    Please enter the mobile phone number of the coordinator
  14. Accounts Contact
  15. Name*
    Please enter the first name of the coordinator
  16. Position*
    Please enter the position of the coordinator
  17. Email Address*
    Please enter the email address of the coordinator
  18. Mobile Number*
    Please enter the mobile phone number of the coordinator
  19. Bank Account Details
  20. Bank Account Name*
    Please enter the first name of the coordinator
  21. BSB*
    Please enter the position of the coordinator
  22. Account Number*
    Please enter the email address of the coordinator
  23. Bank Institution*
    Please enter the mobile phone number of the coordinator
  24. Close Date for Orders Online
  25. Please select a close date for orders placed online*
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  26. Authorised Signature*
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  27. Type your full name to accept the Terms & Conditions of Use*
    Please enter your promotional code
  28. Terms & Conditions of Use
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  29. *
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