Name: 

Surname: 

Date of Birth:  

Sex:  

Address:  

Suburb:  

Post Code:  

State:  

Phone Number:  

Email Address:  

Occupation:  

Business 
(If Applicable): 

Promoting History : 

Do you promote for 
anyone else? : 

What are you actively doing in terms of promoting?

Are you interesting in becoming part of the distribution team- advertising material, putting up posters, shop drops etc? 

Interesting in going around with the mailing list on the night? 

Interested in active promoting (handing our flyers on the street)- shopping centers, city aka Rundle St, Hindley St, Nth Adelaide, Uni's, other events etc. 

Comments & Suggestions: