JOIN THE LINE
SUBMISSION FORM


Use this form to list your upcoming events.

We Invite You To Donate to THE BEAT CHARITY ACCOUNT

using your Internet Banking or we will invoice you later.     

Please include full details of event, including date, time, venue and contact phone number. 

           


        NAME: 

        STREET ADDRESS:

        CITY & POSTAL CODE:

        COUNTRY:

        PHONE:

        MOBILE: 

        EMAIL: 

        EVENT DETAILS #1: 


        EVENT DETAILS #2: 


        EVENT DETAILS #3: 



        PAYMENT METHOD

        NZ customers only: 

        You can now make a donation online direct through your internet banking. 
        Charity Account details are:
        020820 0056421 97  
        Please ensure you use your surname and membership number as a reference

        or your surname or group and last four digits of your phone number as a reference. 



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