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Club CareFlight Application Form

Club CareFlight Application Form

Select your support level for Club CareFlight Membership

Supporter Level

Bronze Membership - $1,000 inc. GST

Silver Membership - $3,000 inc. GST

Gold Membership - $5,000 inc. GST

Platinum Membership - $10,000 inc. GST

Your contact details:

Your name(Required)

First name Last name

Business name(Required)

ABN(Required)

Phone number(Required)

Email(Required)

Business address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Preferred payment method(Required)

Bank Deposit

BPAY

Credit Card

Is your business registered for GST?(Required)

Yes

No

Invoicing details:

Please provide alternate accounts details for invoices to be sent to if required.

Invoice contact details

As above

Accounts contact name

First name Last name

Accounts phone number

Accounts email address

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A member of the Club Careflight team will contact you to provide payment details.

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Call 1800 655 876 (toll free)

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Copyright © 2023 CareFlight – all rights reserved.
ABN: 18 210 132 023 Registered Charity Number: ACN: 003093445 RTO Code: 40803
Fundraising Authority Numbers: NSW 11649; VIC 15100; ACT 190000320; WA 21207; TAS C/133; SA: CCP3396

CareFlight acknowledges the traditional owners and custodians across the lands on which we live and work, and we pay our respects to the elders past and present.

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