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

Group Details
Group Name*
Please enter the name of your school or organisation
Address*
Please enter your organisation's or school's street address
Suburb*
Please enter your suburb
State*
Please select your state or territory
Postcode*
Please enter your postcode
Phone*
Please enter the daytime phone number of the coordinator
Contact Details
Name*
Please enter the first name of the coordinator
Position*
Please enter the position of the coordinator
Email Address*
Please enter the email address of the coordinator
Mobile Number*
Please enter the mobile phone number of the coordinator
Accounts Contact
Name*
Please enter the first name of the coordinator
Position*
Please enter the position of the coordinator
Email Address*
Please enter the email address of the coordinator
Mobile Number*
Please enter the mobile phone number of the coordinator
Bank Account Details
Bank Account Name*
Please enter the first name of the coordinator
BSB*
Please enter the position of the coordinator
Account Number*
Please enter the email address of the coordinator
Bank Institution*
Please enter the mobile phone number of the coordinator
Close Date for Orders Online
Please select a close date for orders placed online* / /
Invalid Input
Authorised Signature*
Invalid Input
Type your full name to accept the Terms & Conditions of Use*
Please enter your promotional code
Terms & Conditions of Use
Invalid Input
*
Invalid Input