1. Your Donation

Donation Type

If you'd like to make a regular (monthly, weekly or fortnightly) donation please call us on 6231 1065, or email us at info@ultra106five.com, and we'll set it up for you.
Donation Type*
- Once-Off Gift
- Monthly Gift
Your Gift Amount*
- $50
- $106.5
- $365 (dollar a day)
- $1065
- Other Amount
Other Amount
2. Credit Card
Card Details*

American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiry Date Security Code Cardholder Name
3. Your Details
First Name*
Last Name*
Organisation
Email Address*
Address
Street Address Suburb State Post Code Country
Phone*
Comments
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Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Phone*
Email*
Contact details for a character reference
Name*
Contact number*
Relationship (eg: pastor, friend, colleague)*
Areas of interest for volunteering*
- Select All
- On-air announcing
- Audio production
- General administration
- Events
- Prayer team member
- Appeal support team
Select as many as apply
Why do you want to volunteer with Ultra106five?*
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Event Featured Image*
Accepted file types: jpg, jpeg, png, gif, Max. file size: 5 MB.
Drag file here or browse

Max 5MB of PDF or image (jpeg, jpg, png,gif) file can be uploaded.
Title*
Description
Location
Start Date
DD slash MM slash YYYY
End Date
DD slash MM slash YYYY
Start Time

: HH

MM
End Time

: HH

MM
Event Photos
Drop files here or

Accepted file types: jpg, jpeg, png, gif, Max. file size: 5 MB.
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Register to be a member of the Ultra106five Family Club for access to on-air competitions, newsletters, and exclusive offers straight to your inbox!

First Name*
Last Name*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Email Address*
Phone*
Ts and Cs*
I have read and understood the Competition Terms and Conditions
Mailing List*
By joining the Ultra106five Family Club I agree to have my personal details added to a mailout list. I understand that I can update my preferences or unsubscribe at any time.
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