Fundraiser Registration
Please register your fundraiser with us, By registering we will be able to provide some assistance with your fundraiser. Once you register we will send out an information pack and a fundraising agreement. please reach out to us if you have any questions before registering - info@nationalmsaresearch.org.au
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: 0000 000 000.
What Fundraiser are you planning
*
Move4MSA
Other type of Fundraiser
What type of fundraiser are you planning to host
*
What is the proposed date of the fundraiser?
*
-
Month
-
Day
Year
Date
Would you like the agreement form sent to you?
*
Please Select
Yes
No
What state will the fundraiser be held?
*
Please Select
Victoria
New South Wales
Queensland
South Australia
Western Australia
Northern Territory
Tasmania
Canberra
Please verify that you are human
*
Submit
Should be Empty: