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Cancer Society Otago/Southland Division Fundraising Proposal
Organisation Name if applicable:
Title
*
Please select
Mr
Mrs
Ms
Dr
Prof
Rev
Justice
Lady
Sir
First name
*
Surname
*
Email
*
Daytime contact number
*
Mobile Phone
Postal Address
Address 1
*
Address 2
Suburb
*
Town/City
*
Postcode
*
Fundraising Activity/Event Details
Name of fundraising activity / event
Date effective from
*
DD
/
MM
/
YYYY
Description of your fundraising activity/event
*
Do you wish to use the Cancer Society name / logo on any promotion material?
*
No
Yes
Terms and conditions*
*
I Agree
The Cancer Society Otago/Southland Division must approve all publicity and printed material bearing the Society's name and / or logo prior to its production and release
The Cancer Society Otago/Southland Division will receive all net funds promised at the fundraising activity or event within 45 days of the conclusion of the activity or event.
Promotion
*
No
Yes
I authorise the Cancer Society Otago/Southland Division to publicise the said event and/or activity in its public relations e.g. Link newsletter, Cancer Society Otago/Southland Division website or other print media
Please submit this form and someone from our fundraising team will be in contact with you as soon as possible. Thank you
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