Fundraiser Form

If you would like to fundraise for Melanoma Institute Australia, please complete the form below.

Please note you do not need to complete this form if you have set up a Fundraising Page on our Community Fundraising website.

If you have any questions please email Peta at Peta.Bradshaw@melanoma.org.au

First Name *

Last Name *

Street Address *

Suburb *

State *

Postcode *

Email Address *

Mobile Phone *

Name of fundraising event /activity *

Brief description of fundraising event /activity *

Date of proposed event *

Venue Name *

Venue Address *

Venue contact details *

I support Melanoma Institute Australia because ... *

Please indicate how funds will be raised (e.g. ticket sales, raffles, auction, etc) *

If your event is held outside during the day, what sunsafe protocols will you ensure are in place for organisers and participants? *

What amount are you aiming to raise from this event / activity? *

What are the foreseen costs / expenses to run the event / activity? *

Would you like us to share on social media? (Select Yes or No) *

Would you like to discuss the use of additional Melanoma Institute Australia resources for your fundraiser (such as banners, information booklets etc) (Select Yes or No) *

Terms and Conditions

Under the Charitable Fundraising Act 1991, Melanoma Institute Australia (MIA) is legally required to authorise all community
fundraising events/activities that are wishing to raise money for charitable purposes. Once your event/activity has been
approved, MIA will issue you with a letter of authority to fundraise which states your legal authority to fundraise on our behalf.
Please note all individuals, organisations, and groups must register with us before organising and holding their event/activity.

Please read these guidelines: Melanoma Institute Australia Fundraising Guidelines. Then confirm by ticking the box below and submitting your form.

I have read and understand the terms and conditions stated in the Melanoma Institute Australia Fundraising Guidelines under which any fundraising activities benefiting Melanoma Institute Australia (MIA) need to operate. I will endeavour to ensure that MIA representatives are informed of the development of any fundraising concepts and approve any promotional material or media releases citing MIA as the beneficiary. I understand my obligations with regards to sending the proceeds raised and other documentation to MIA within 7 days of the event/activity.

Tick box *

I agree to hold my event in a manner which upholds MIA's integrity, professionalism and values, as outlined in the MIA guidelines.

Fundraiser Full Name *

Event / Activity Name *

Date Submitted *

Thank you for contacting us about your proposed fundraising event / activity. We will be in touch soon.

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