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If you are a key representative in your Organisation, please register to receive the rebate when a supporter of your organisation joins Agapenet. Please enter your Organisation details below.
Contact Name:
Contact E-mail address
Contact Phone:
Your Organisation Name:
Organisation Phone:
Address:
Postal Address (if different):
City:
State:
PostCode:
Organisation A.B.N:
If no A.B.N is supplied, a statement in accordance with ATO rules is required.
We may contact you for further information if necessary.
We reserve the right to approve or reject any application for registration without explanation or notification. All registrations, either e-mailed, posted, personally hand delivered or faxed are subject to these conditions without exception.
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