Fundraise for Wishlist (Form 1)

Fundraise for Wishlist

Thank you for supporting Wishlist and your interest in fundraising! Before you begin organising your fundraising event, please complete this form. Once we have received your proposal, we will be in contact with you to get you started. Please fill in as much information as you can or
write N/A if not applicable.

I want to

Fundraise for a specific purpose

Fundraise in general

Organise an event

Make a donation

A gift

Sponsorship

Form Page Break #1

Fundraiser/Event coordinator details

Name *

First name

Last name

Organisation/Company name

Position

Email address *

Phone *

Address *

Address line 1

Address line 2

City/Suburb

State/Territory

Postcode

Country

Website (if applicable)

Do you have a preference for where Wishlist directs proceeds of your fundraising efforts *

Yes

If you answered "yes" to the above question please indicate where you would like your funds directed

Have you fundraised for Wishlist previously? *

Yes

If "yes" please provide details

What inspired you to raise funds for Wishlist?

Form Page Break #2

Fundraiser/Event

Tell us briefly about your fundraising event (plan, number of people attending, how funds will be raised, etc) *

Proposed date / timeframe of your fundraising event

Address/venue of fundraising event

Form Page Break #3

Administration

Are there any resources you need from Wishlist to make your fundraising event a success? Please select below

Advice or assistance planning your event/activity

Online registration & payment via Wishlist website

Signage

Donation tins

Brochures/marketing collateral

Receipt books

Publicity and promotion

Wishlist representative

Other (Please specify)

Do you intend to use Wishlist's logo on any marketing collateral?

Yes

If "yes" above please specify where you would like to use the Wishlist logo

Do you plan to hold fundraising events for Wishlist on an ongoing basis?

Yes

Form Page Break #4

Fundraiser/Event Budget

How much do you hope to raise?

Will another organisation benefit from the fundraising?

Yes

If yes, please state the name of the organisation and percentage of funds they will receive

Form Page Break #5

Disclaimer and Fundraising Agreement

Wishlist reserves its right to withdraw its approval for the Fundraiser/event at any time if it appears that there is a likelihood of the Fundraiser failing to adhere to any of the above terms and conditions. In consideration of my application being accepted, I understand, intending to be legally bound for myself and my heirs, executor and administrators, waive and release the organisers and sponsors (individually and collectively), including the directors, officers, staff, volunteers and representatives thereof, and indemnify them against any liability (including liability for negligence) for the death or any physical or mental illness, incapacity or property damage or loss which I may suffer which may directly or indirectly result from my participation in the event/fundraiser. I further verify that I am in proper physical and mental condition to participate in the fundraiser and acknowledge that I am aware of the risks involved and voluntarily agree to assume those risks.

1. I (Coordinator’s name) accept the terms and conditions of the Fundraising Guidelines. *

2. I agree to conduct my fundraiser/event in accordance with those terms and conditions and in a manner, which upholds the integrity, professionalism and ethos of Wishlist.

3. I have read and I agree to abide by the fundraising rules and guidelines of Wishlist and indemnify Wishlist from and against any claims for injuries or damage arising at or from the event/fundraiser that is the subject of this application.

Date

Thank you for supporting Wishlist.

info@wishlist.org.au

07 5202 1777
wishlist.org.au