Fundraising Registration Form

  • Personal Details
  • Person to contact who is coordinating the event or activity
  • Event Details
  • Date Format: DD slash MM slash YYYY
  • Date Format: DD slash MM slash YYYY
  • Please be as detailed as possible.
    Please specify if you agree to allow QEI to promote or publish details of your event.
    I agree to act in a professional manner in conducting the fundraising activity and uphold the integrity and values of the Queensland Eye Institute. I also accept my obligation to remit the funds raised to the Queensland Eye Institute within 14 days of the event conclusion. You will be contacted by a fundraising team member with the full terms and conditions for fundraising on behalf of QEI. Prior to publicising or conducting any event you must obtain Queensland Eye Institute's approval.