Wellbeing Priori-Tea Registration
Conversations and connection for mental health & wellbeing
Contact Name
First Name
Last Name
Organisation/Business/Group
Email
example@example.com
Phone Number
-
Area Code
Phone Number
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Expected attendance
Will you be raising donations for mental health organisation?
Please Select
Yes
No
Unsure
Please note: if you do wish to raise donations for a charity of your choice this agreement will be between you and your chosen charity. MHCC ACT(coordinator of MHM ACT) is not responsible for any funds raised at your event.
What is the mental health organisation you will raise funds for?
Please provide a brief description of what you plan to do at your Wellbeing Priori-Tea event:
Ie. when, where and any exciting ideas!
Please provide your business or organisation logo if you wish to be added as a partner on the Wellbeing Priori-Tea webpage.
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