Application Form

(If translated)

Your details…
Note: Your full contact details are required for your application to be considered. If you do not want certain details to display on the web site, it is possible to hide them after you receive your account details.
Registering as:	Account Types Q & A
Company/Organisation Name:	(If applying as Company or Organisation)
Firstname:		Phone:
Surname:		Email:
Address:		Confirm Email:
Address (cont.):		Web site
Area/Suburb:
City/Town:
Postcode/Zip:
Tell us how you heard about Plan de Apoyo Mutuo and why you want to join:
Subject:

Offerings Please enter below details of the services and/or goods you will be offering. Please use the format shown. NB: Applications with no offerings will not be considered. The Plan de Apoyo Mutuo is about giving as well as receiving. All rates must be expressed in Pams. A Dollar component is permissible but it should not exceed the Pam component. Please try to fill in all three offerings fields. You may edit these and add further offerings when you get your account. 1 Pam ($P) ≈ 1 Dollar ($) Offerings Q & A Click here to see what's available from Plan de Apoyo Mutuo
Example: Massage	I do full body, deep-tissue massage.	$P40 / hour
Heading:	Details:	Rate:
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Wants: You may optionally enter any wants or requirements that you might have.
Example: Bed and mattress	I am looking for a full-sized, single-width bed and mattress. Anyone have one?
Heading:	Details:
Heading:	Details:
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