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National Palliative Care Week 2019: Resource Order Form
Contact Details
1.
Please provide your contact details:
Contact Name
Organisation
Organisation Address
Organisation Address 2
Organisation City/Town/Suburb
Organisation State
Organisation Postal Code
What is your role in your organisation?
Email Address
Phone Number
2.
If your organisation a Organisational Member of PCQ?
(please note this is not essential to request resources for national palliative care week)
Yes
No
We're planning to join
Other (please specify)
3.
Will your event include raising funds/collecting donations for Palliative Care Queensland?
Yes
No
Other (please specify)
4.
We encourage you to consider selling some PCQ "I Care for Palliative Care" merchandise at your event?
Please see the list below and enter the amount you would like us to send or deliver to you
(please note all unused merchandise must be returned or purchased).
View the merchandise here: https://palliativecareqld.org.au/i_care_for_palliative_care/
Fridge Magnets (business card size)
Badge (small)
Mug
T-Shirt
Drink Holder
Bumper Sticker
Tote Bag (minimal available)
