Charity Application Form

Organisation Type
Full Name *

First Name Last Name
Position
Phone
E-mail *
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Purpose of event/activity *
If the event/activity is to raise funds for an official charity, do you have permission to fundraise?

Yes No
Event Date

Month Day Year
Event Location
Event Type
Item Requested *

Ball Jersey Promotional Items (e.g. stickers/poster)
Previous Support from Rugby AU
Additional Information
Should be Empty: