Event Reconciliation Form

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Entrant Details

Variety Event(Required)

SA Variety Bash

Variety SA 4WD Adventure

Variety Moto Run

Variety Aussie Muscle Car Run

Other

Please select which event you are fundraising for

Entrant Name / Number(Required)

Full Name(Required)

Event / Fundraiser Coordinator(Required)

i.e. Car Caption / Team captain etc.

Type of Event(Required)

Date of Event(Required)

Location(Required)

Venue(Required)

Email Address(Required)

Income

*(proposed if prior to fundraising) - Please fill out all sections relevant to your event / fundraiser.

Ticket Sales ($)

Auction ($)

Donations ($)

Lucky Ticket Draw ($)

Raffle ($)

Other ($)

If other, please describe the method used to generate income + the amount raised. (i.e. Bake Sale - $150)

Total Income ($)(Required)

Expenses

Please attach receipts below and fill out all sections relevant to your event / fundraiser.

Please upload receipts / invoices

Drop files here or

Accepted file types: jpg, gif, png, pdf, Max. file size: 128 MB.

Venue ($)

Food & Beverage ($)

Auction Items ($)

Printing ($)

Entertainment / MC ($)

Misc Expenses Under $100 ($)

Credit Card Facilities ($)

Other ($)

If other, please describe the method used to generate income + the amount raised. (i.e. Bake Sale - $150)

Total Expenses ($)(Required)

Total Profit ($)(Required)

Please include any relevent points of information

Payment Method to Variety

How will the funds be sent to Variety(Required)

Cash or Cheque

EFT - Online Bank Transfer

Pay with Credit Card now

Total amount you would like to pay now(Required)

Total

Credit Card(Required)

American Express

Discover

MasterCard

Visa

Card Number

Expiration Date

Security Code Cardholder Name

EFT Transfer Details

For electronic transfers:

Account Name: Variety - the Children's Charity Tent 75 SA Inc
Account Number: 175 100 858
BSB: 633 000

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Variety South Australia