Mater Foundation

Please note that * denotes a mandatory field

I am joining the Mater Fundraising Challenge as a (choose one option):*

Main Contact: Who should we direct our communication to?

First name:*

Family name:*

Team or school name:

Email address:*

Would you like to recieve regular updates about Mater Foundation activities and events?:*

YesNo

Address 1:*

Address 2:

City/ suburb:*

State:*

Postcode:*

Phone (home):*

Phone (mobile):

About you: Providing this information helps us get to know you

Reason for joining the challenge (please tick as many as apply):*

I have been a patient at the Mater
A family member or friend has been a patient at the Mater
To support research at the Mater
To support the Mater in general
I am Mater staff
Other

If 'other' please provide more information:

How did you hear about the Mater Fundraising Challenge? (please tick as many as apply):*

If 'other' please provide more information:

How do you keep up to date with friends, family, news and information? (please tick as many as apply):*

If 'other' please provide more information:

Fundraising Challenge Form

Mater Fundraising Challenge - Registration