CONFIRMATION FORM

Thank you for partnering with us at the 2018 QCOSS State Conference - Movement for change.

On receipt of this form you will be sent a Tax Invoice.

If you have any questions, please contact Marie Noy on (07) 3004 6900 or marien@qcoss.org.au
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* 1. ORGANISATION DETAILS

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* 2. CONTACT DETAILS

All correspondence regarding this partnership agreement will be forwarded to this person.

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* 3. PLEASE SELECT THE PACKAGE OF YOUR CHOICE

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* 4. TOTAL PARTNERSHIP AMOUNT $

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