Cancer Council SA

Community fundraising form

Applicant Details
Confirm

Applicant details

* First name

* Last name

Organisation

* Street

* Suburb

* State

* Postcode

** Phone

** Mobile

* Email

Date of birth

I am organising this fundraiser/event in honour of (if applicable)

* What is your motivation for fundraising for Cancer Council SA?

* Please indicate which states you will be fundraising in

* How did you hear about fundraising for Cancer Council SA?

Event information

* Name of event

* Event date

* Which of the following best describes the type of fundraising you would like to undertake?

* Please describe your proposed activity

Venue name and address of event

* What methods will you be using to raise money?

* Do you intend to seek sponsorship?

If yes please supply Cancer Council SA with a list of proposed sponsors and details

* Do you plan to make this event annual?

Please note that each new event must be registered independently

* Do you plan to involve groups of children in your fundraising?

Cancer Council support

Please note: we will contact you about your requirements. All support/assistance is subject to availability

I would like to request the following support/assistance from Cancer Council SA

Assistance - other

Is there a particular cancer/cancer issue you would like more information about?

* Cancer Council SA cannot provide you with public liability insurance. Do you intend to seek public liability for your fundraising activity?

Budget information

What is your fundraising target for Cancer Council SA (please estimate) $

* Will another organisation benefit from the fundraising?

If yes, please state which organisation

What percentage of funds will be given to Cancer Council SA?

Referees

Please provide us with the details of a contactable referee

* Name

* Phone

Declarations

Cancer Council SA Community Fundraising Guidelines

I have read Cancer Council SA's Community Fundraising Guidelines carefully and understand its content. I agree to conduct my event in accordance with these guidelines and to make every effort to uphold the reputation of Cancer Council SA. I understand that I cannot claim against Cancer Council SA for any damage or injury incurred as a result of this fundraising event.

* Do you agree?

I understand that Cancer Council SA reserves the right to withdraw approval of this event at any time, should the event or the event organiser(s) fail to comply with Cancer Council SA's Community Fundraising Guidelines. I understand that Cancer Council SA and all its staff, officers and volunteers cannot be held responsible for any loss or damage that occurs as a direct or indirect result of this event. I am in a suitable physical and mental condition to organise and run this event and have considered any and all risk that may be associated with this event.

* Do you agree?

Privacy collection statement

Your privacy is as important to Cancer Council SA as it is to you. That's why any personal information you give us will be treated with respect and in strict confidence. Personal information is collected to process donations, issue tax receipts and to send you updates. We may disclose your information to agents, contractors and third parties who provide services to us, and in doing so we take reasonable steps to ensure any information held by our service providers is protected. A full copy of our Privacy Policy is at www.cancersa.org.au/privacy with details about how you can access and correct your personal information and how we handle any privacy complaints. Or call us on 1300 65 65 85 for more details about our commitment to your privacy.

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