Host an Assembly Day

Date*

Number of kits to be assembled*

Please note: Birthing kits are supplied in increments of 200.

What type of kits would you like to pack?*

Assembly Coordinator's Name*

Mobile/Phone

Email*

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

If Yes, please name the club

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

Which Zonta Club if you selected 'yes' above

Which Zonta District?

Club/Organisation/Group email

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*

Telephone/mobile 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*

We require your booking form submission 8 weeks prior to the date of your Assembly Day.

How did you hear about BKFA?*

If other please specify

Name

This field is for validation purposes and should be left unchanged.