Host an Assembly Day - Birthing Kit Foundation Australia

Date*

Number of kits to be assembled*

Please note: Birthing kits are supplied in increments of 200. ($1000)

Assembly Coordinator's Name*

Phone*

Email*

Are you part of a Club/Organisation/Group?*

If yes, please name the club*

Club/Organisation/Group email*

Are you holding your day in association with a Zonta Club?*

Which Zonta Club (if you selected 'yes' above)*

Which Zonta District?*

Invoice addressed to:*

Invoice payer/Club Treasurer’s Email*

Expected number of volunteers (for glove supplies)*

Purpose of Assembly Day*

e.g birthday, baby, shower, anniversary, general fundraiser, in memory

Delivery Address for Assembly Day Supplies (No PO Boxes)*

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

Business/Person’s name*

Phone number*

I will ensure payment is made 4 weeks prior to assembly date or I will contact Bookings@bkfa.org.au*

I will ensure payment is made 4 weeks prior to assembly date or I will contact Bookings@bkfa.org.au

I confirm I have ensured public liability insurance is in place*

I confirm that I have read and understood the Assembly Day manual*

The venue for the Assembly Day is a safe working environment*

How did you initally hear about BKFA?*

If other please specify*

What prompted you to book this time?

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