Fundraising Application Online Form

Contact Name:

Organisation: (if applicable)

Address:

Suburb:

State:

Postcode:

Email:

Phone Number:

Please tell us why you have chosen to fundraise for headspace:

Name of your proposed activity:

Brief description of proposed event:

Proposed date of your activity:

Location of your activity:

Are there any potential sponsors or other organisations involved in the proposed event?

Are there any other not-for-profit organisations involved in the proposed event: If so, please list them?

How many people do you expect to attend?

Will there be any alcohol available or sold at the proposed event?

How do you intend to promote the proposed event?

Estimated number of attendees at the proposed event:

Estimated total income (funds raised) from the proposed event:

What, if any, insurance coverage are you required to have for your proposed event?

Before you submit your application please read the headspace Fundraising Guidelines for your state or territory.

The funds are being raised to support the national work of headspace.

(If you are looking to support your local headspace centre then you will need to reach out to that centre directly, via the centre page)

I agree that I have read, understood and agree to comply with headspace Fundraising Guidelines of my state or territory.