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(OLDP/SF/04)
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Please fax to Planning and Development Department/NCSS at 6462 - 4609
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OLDP
SUBSCRIPTION FORM
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| SUBSCRIBER DETAILS: | |||
| My organisation would like to subscribe to the Online Donation Portal (OLDP) and agree with the costs, responsibilities and the requirements as outlined in the "Information Note of the OLDP" (OLDP/INF). | |||
| Name of Organisation (Subscriber) - PLEASE PRINT: | |||
| _________________________________________________________________ | |||
| Correspondence Address of Subscriber - PLEASE PRINT: | |||
| _________________________________________________________________ | |||
| _________________________________________________________________ | |||
| Name of Contact Person - PLEASE PRINT: | |||
| _________________________________________________________________ | |||
| Contact Tel. Nos.: _________________________________________________ | |||
| Contact Fax. Nos.: _________________________________________________ | |||
| Email Address of Contact Person - PLEASE PRINT: | |||
| ________________________________________________________________ | |||
| _____________________ | _________________________ | _______________ | |
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Name/Designation
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Signature
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Date
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(PLEASE PRINT)
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| Planning Division NCSS Dec 2003 |
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