EmailMeForm
Overnight Holiday/Camp Requests
Current Date
*
DD
/
MM
/
YYYY
Start Date
*
DD
/
MM
/
YYYY
HH
:
MM
AM
PM
AM/PM
End Date
*
DD
/
MM
/
YYYY
HH
:
MM
AM
PM
AM/PM
Program
*
Please select
Admin Sydney
Admin Newcastle
Barnier Mittigar
Craddock - Boab
Earle Jasmine
Farrington - Willow
Flemming- Bindi
Fourth Birch Grove
Gistford Banksia
Hazel
Highpoint
Lee Yurana
Nari
Patricia Rainbow
South - Paterson
Other
Other
*
Contact person
*
Email
*
Position
*
HC
RPM
Director
Other
RPM's name
*
Domara Kertabani
Ben Taylor
Gus Morgan
Brant McKenna
Diana Musa
Cost Information
Client name(s)
*
Please include full client name(s)
Cost of Travel - Petrol, Flights, Trains etc.
*
$
Dollars
.
Cents
Cost of Accommodation
*
$
Dollars
.
Cents
Any additional costs
*
$
Dollars
.
Cents
Details of trip
*
Staff requirements
*
Support documentation
Please attach what the house roster will look like for this period - does not require staff names, only requires the hours.
Also attach any quotes for accommodation, flights etc.
Document uploads
*
Add File
Payment processing
This is to be processed as
Transfer to house
Third party payment
We prefer, as much as possible, to make the payment directly to the third party.
Third Party payment mode
Direct transfer to bank account
Credit/Debit Card
Account name
BSB
Account number
Description on recipient's statement
18 characters limit
Web Site for payment by Debit Card
Any relevant info/comments