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.