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MND Ice Bucket Challenge

Proposal to Fundraise

Thank you for your interest in fundraising for Motor Neurone Disease New South Wales (MND NSW).

Before you begin organising your Ice Bucket Challenge fundraising event, please read the Fundraising Guidelines and then complete the form below.

In order for a person to collect money on behalf of MND NSW they must have an Authority to Fundraise issued by MND NSW.

Tell us a little more about you and your Ice Bucket Challenge fundraising event

OR

I would also like to fundraise with a:

Merchandise Stall
Raffle
Donation Tin
Where it's most needed by MND NSW
Equipment
Support
Education and Information
Carers Support
Research
Yes
No

NOTE: Authorised fundraisers for MND NSW are covered by its public liability insurance policy - subject to approval - for the
period of authorised fundraising. We can supply you with a copy of our public liability certificate of currency if required.  

Tell us how you plan to promote your event

Please note, copies of any promotional materials must be submitted to MND NSW for approval prior to release.  

(The names of sponsors promoted or used must also be submitted to MND NSW to allow us to ensure there is no 
conflict with our policies.) 

Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No

Please advise your preferred contact for social media: 

Fundraising Agreement and Guidelines

I have read and agree with the MND NSW Fundraising Guidelines. (View the Fundraising Guidelines here)

I agree to conduct my Ice Bucket Challenge fundraising event in accordance with the terms and conditions set by MND NSW, and in a manner which upholds the integrity, professionalism and values of MND NSW.