Corporate Interest Registration Form

If your organisation is interested in getting involved please fill out this form and we will get back to you soon.

Salutation:

First Name: *

Last Name: *

Company: *

Position with Company/Organisation:

Company Street:

Company City:

Company State/Territory:

Company Postcode:

Phone:

Mobile:

Email: *

Website:

Raised funds for Lifeline before?: *

Please give details about funds raised:

What has inspired you to raise funds?:

Tell us more about how you plan to support Lifeline Australia: (please tick relevant boxes – can be more than one) *

External Marketing

Workplace Giving

Staff Fundraising

Volunteering

Event Sponsorship

Pro bono and in-kind support

What is your annual fundraising target?:

Tell us briefly about the initiative (300 characters):