Registration | Parma for a Farmer

Register your venue to be a part of the amazing Parma for a Farmer campaign supporting rural communities and farmers across Australia.

Contact Name*
First Last
Venue Name*
Would you like to participate in this years Parma for a Farmer campaign?*
- Yes
- No
Please check and update all pre-filled fields if any changes are necessary.
Venue Address*
Street Address Suburb City State Postcode
Is venue address same as the postal address?*
- Yes
- No
Postal Address
Street Address Address Line 2 City State Post Code Country
Email*
Enter Email Confirm Email
Website
Phone*
Fundraising Goal? (Numbers Only)
Logo
Please upload your restaurant/club/hotel logo.*Maximum file size should be of 8MB.
Your business will start promoting the campaign from
Date Format: DD slash MM slash YYYY
Would you like to have donation barrels at your venue?*
- Yes
- No
How many donation barrels you would like to have?*
Barrrel Number
Number of Barrel Sent?
Number of barrel returned?
Barrel issued on?
Date Format: DD slash MM slash YYYY
Barrels returned on
Date Format: MM slash DD slash YYYY
Facebook Page URL:
Instagram page URL:
Any special notes
Additional Hidden Content
Contact Type
Account Type