Form

Registration Form: Site Space

Company/Trading Name

ABN

Contact Name

Mobile

What will you sell?
Be specific (e.g. clothes, type of food, type of jewellery) list everything.
Please note: You can only sell what you have listed.

Certificate of Currency (PDF)

Payment: $275 (inc GST)

Credit Card

Bank Transfer

Card Number

Expiry

CVC

EFT Details:

Name: Rotary Club of Lane Cove
BSB: 032085
ACC: 484417
Applications without a payment will not be considered.

I agree to the terms & service.