Premah Sponsor Program Registration Form

Thank-you for becoming a Premah Sponsor!

By becoming a Premah sponsor you are now supporting a local person in need. Each sponsorship you provide will be a huge step in changing this person’s life! This sponsorship will pay for a psychology, counselling or coaching appointment along with case worker follow-ups and education. All of this will be provided, one-on-one, for your sponsored person. We will present you with updates of who you helped and what your support and generosity has done for them. Your sponsored person will be aged 24 and under and will be from your local community.

From Premah and your local community we are sincerely grateful

Upon completion of this form, Premah will issue you with an invoice for the amount stated below. Payment terms are 7 days unless otherwise agreed upon or with multiple sponsorships, instalments are permitted.

1. Name:

2. Contact Phone #

3. Email: This question requires a valid email address.

4. Company:

5. Postal Address:

Each Sponsorship cost is $245.00 (if more than one Sponsorship is purchased, you can pay via monthly direct debit instalments)

6. Number of sponsorships you would like to provide:

7. How would you like to provide support:

Remember, you will have feedback as to who you have helped (age and gender), and how this has improved their life.

9. Any requests you would like to add?

Keep an eye on our Facebook page for your pictures and thankyous! https://www.facebook.com/PremahPtyLtd/

Please note: if you Sponsorship is not used within 12 Months you can roll it over or request a refund.