Mr & Mrs
Are you doing this on behalf of a company?
Phone (please include your area code)
Have you raised funds for the ACRF before?
Name of Fundraiser/Event
Description of the activity or event including venue or location
Proposed date / timeframe of your fundraiser
Support ACRF in its mission to outsmart cancer
Relative or friend affected by cancer
I have personally been affected by cancer
How much money do you aim to raise for the ACRF?
$1 - $999
$1,000 - $4,999
$5,000 - $9,999
$10,000 or more
Are you over 18?
Tick to confirm that you have read and agree to abide by fundraising guidelines and legislation (found on the right of this form).