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Fundrasing Form

".......you and InkXpress are stars!  I love getting donations without even trying."
Kay - Childrens Food Education

Please complete the form below and then press the Submit button.

Application Form - InkXpress Fund Raising Program

Organisation Name :
Street Address :
Suburb :
State :
Postcode :
Phone :
Fax :
Email :
Business (type) :
ABN :
Registered Charity (#) :
Applicant Name :
Applicant Role :
How often would you like to receive the donations ?
How would you like to be paid ?  
Cheque : Payee Name
Direct transfer : (i) Account Name
  (ii) Account Number
  (iii) BSB
  (iv) Name of Bank
B-Pay : Biller Code
  Ref
   
How you found out about us, and any other comments :
 
   
Upon receipt of this form and confirmation of authenticity, your organisation will appear on the InkXpress web site as eligible for receipt of donations from our customers.
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