HOME | WHAT WE DO | STAGE OF ORIGIN | MULTIMEDIA | WHO WE ARE | CONTACT TICKET DISTRIBUTOR SPONSORS Stage of Origin 2012 Official Tickets Distributor Registration Form Fill out the form below to register yourself as an Official Tickets Distributor. Fields marked with a * are required. Organisation Name: Organisation Type: (Charitable trust, sports club..etc) Applicant Name: * Street Address: P.O Box: Email: * Phone (Day): Phone (Night): Mobile: Contact Person: * Reason for Fundraising: Sports fees, church group..etc Do the funds raised through the sale of the tickets to the event "Stage of Origin 2012" be used for what is termed "Authorised Purpose" as set down by the Department of Internal Affairs? Authorised Purpose may include charitable, philanthropic, amateur sporting, cultural activities or something that provides benefit to a significant portion of the community in a non-commercial sense. Type Charitable: Yes No Philanthropic: Yes No Amateur sporting: Yes No Cultural activities: Yes No Other: Specify Tickets Available For Rotorua Energy Events Centre Cost $5.00 - Re-sell for $25.00 for General Admission Seating ($5.00 for admin cost + $20.00 profit per ticket for your organisation) How many tickets do you wish to purchase for re-sale? 30 Tickets 50 Tickets 100 Tickets Should you sell all your tickets, would you require more? Yes No Should your group be fundraising for domestic or international travel, would you like Pronesia to refer your details, for possible group discount travel? Yes No Terms and Conditions * By checking this box, you agree to the Terms and Conditions. You must agree to the Terms and Conditions to proceed Click the submit button below to continue. Looking for a great way to fundraise for your Community or Sports group? Click on "Register Now" to ensure your group doesn't miss out on Stage of Origin 2012. © COPYRIGHT 2012 PRONESIA.