RESTART SEQ
Home
About Us
Please help me!
Donations
Sponsorship
Donors
NRL Raffle
Brick wall
Contact
Brickys payment page
Gold sponsorship
Home
About Us
Please help me!
Donations
Sponsorship
Donors
NRL Raffle
Brick wall
Contact
Brickys payment page
Gold sponsorship
I am restarting. Please consider me for assistance...
To enable us to help you correctly, please answer ALL the questions below.
P
lease
note:
We DON’T bring NEW furniture but we won't bring junk!
We supply ONLY high quality second-hand / reconditioned products.
*
Indicates required field
Full name
*
First
Last
Phone number
*
Email
*
Address
*
Line 1
Line 2
City
State
Zip Code
Country
How many People are there in your group?
*
Please place Ages as well
Child 1 M/F Age ?
*
Child 2 M/F Age?
*
Child 3 M/F Age ?
*
Child 4 M/F Age?
*
Are you restarting after:
*
DV less then 6 months ago
DV more then 6 months ago
Natural Disaster
Other
Homelessness less then 6 months ago
Homelessness more then 6 months ago
If you are escaping DV is there an AVO in place ?
*
Can you please provide a brief description of your situation:
*
What Furniture do You require ?
*
I agree to receiving marketing and promotional materials
Submit
If you don’t hear back from us within 48 hours, please check your Spam/Junk folders or contact us on 0428 758 931
blk