Community Fundraising Registration

First Name

Last Name

Organisation

Phone Number

Email Address

Can we email you about this?

Street Address 1

Street Address 2

Suburb

State

Postcode

Name of Fundraising Activity

Type of activity

e.g trivia night, raffle, stall

Date / Time

Venue

How will funds be raised?

e.g. $5 entry, auction, donation tins

Will there be any other beneficiaries? If yes, please provide details

Total estimated income from fundraising activity:

Estimated Expenses

How will expenses be paid for?

I/we will cover costs Expenses will be deducted from funds raised

Please select all that apply to your fundraising activity

Animals Raffles or Auctions Fireworks Machinery Physical Activity Serving of Food or Alcohol Children

Do you have public liability insurance?

Please note: the RFDS cannot provide public liability insurance for your fundraising activity.

Yes No No but I intend to organise public liability insurance

Where applicable, have you obtained the required permits?

E.g. liquor license, council approval etc

Yes No Not Applicable

If yes, please provide the name of the insurer and the policy number

Do you require any of the following materials?

Small fundraising kit: 2 donation tins, 2 posters, 4 bumper stickers. Medium fundraising kit: 4 donation tins, 2 posters, 6 bumper stickers. Large fundraising kit: 6 donation tins, 4 posters, 10 bumper stickers.

Small fundraising kit Medium fundraising kit Large fundraising kit Custom

If custom is selected, indicate how many donation tins, posters, stickers and brochures you'd like.

Requests for large quantities may need to be reduced.

Would you consider organising this fundraiser again? If yes, how often?

Monthly Annually Bi-annually

Please select if you would like to arrange any of the following

All use of the RFDS logo must have prior approval from the RFDS.

Use of the RFDS logo Other

If you selected other, please elaborate.

We’d love to get to know you.

Thanks so much for giving your support to the Flying Doctor, your kindness will save lives. We’d love to find out a bit more about you and why you chose to support us to ensure what you care about is reflected in what we do:

I have been helped by the Flying Doctor Someone I know has been helped by the Flying Doctor I love in a rural area and know I may need the help of the Flying Doctor in the future I have given previously to the Flying Doctor and wish to do more I received a communication from the Flying Doctor asking for support

Would you like to share any stories or personal experience you have had with the Flying Doctor?

I have read and understood the RFDS Community Fundraising Guidelines

I agree to conduct my event or activity in accordance with the RFDS Community Fundraising Guidelines and in a manner which upholds the integrity, professionalism and reputation of the Royal Flying Doctor Service (Queensland Section). I understand and accept that the RFDS reserves the right to withdraw approval for the fundraising activity at any time if it believes any aspect no longer fits within its fundraising guidelines. I understand I may be required to fill in a Risk Assessment.

Yes No

The RFDS in QLD

* required fields

Your Details

Details of Fundraising Activity

RFDS Support

Disclaimer and Agreement