Referee Match Payment - Payment Details - ACT RUGBY REFEREES ASSOCIATION (ACTRRA)

Referee Match Payment - Payment Details

* Indicates required field

Name *

First

Last

MyRugby ID (if known) *

E-mail address *

What would you like done with your match payments? *

Paid to me Donation - ACTRRA General Account Donation - Will Boyle Fund

If you would like your match payments paid to you, please provide your bank account details below

Please ensure your bank details are correct as ACTRRA or Brumbies Rugby will be unable to recover any payments made to an incorrect account.

BSB *

Account Number *

Account Name *

I consent to ACTRRA receiving and providing the above details to relevant third parties for the purposes of processing my match payments in accordance with the above instructions *

Yes, I consent

Submit