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Contact Name*

First Last

Organization*

Phone*

Email*

Organisation Website

Event Date*

Please describe your event and why it is important to receive donations

How will the donation be used? (check all that apply)*

Please select how Billies Flower House will be acknowledged? (check all that apply)*

Please select how our business will be acknowledged*

Please describe any other ways you will acknowledge the donation publicly

Will you be able to provide a tax deductable receipt? (not required) and if so what is the charity number?

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