Level 2 Western Australia Challenge form
1076
Enter now
Please check the required fields.
true
message
Thank you for your submission.
Sorry, submissions for this form are now closed.
customer-collection
true
text
first_name
First name
half-continuous
true
^[A-Za-z\s]+$
^[0-9]*\.[0-9]*$|^[0-9]+$
Please enter in your first name
true
false
text
last_name
Last name
half-continuous
true
^[A-Za-z\s]+$
^[0-9]*\.[0-9]*$|^[0-9]+$
Please enter in your last name
true
false
email
email_address
Email address
half-continuous
true
^.*$
^[0-9]*\.[0-9]*$|^[0-9]+$
Enter an email address. Your email address must contain an at symbol (@) like this abc@xyz.com.au
true
false
text
agency_name
Agency name
half-continuous
true
^.*$
^[0-9]*\.[0-9]*$|^[0-9]+$
Please enter in your agency name
true
false
number
pcc_iata_tids
PCC / IATA / TIDS Number
half-continuous
true
^[A-Za-z0-9\s]+$
^[0-9]*\.[0-9]*$|^[0-9]+$
Please enter in your Agency PCC, IATA, or TIDS number.
true
false
tel
contact_number
Contact Number
half-continuous
true
^.*$
^[0-9]*\.[0-9]*$|^[0-9]+$
Please enter your contact number
10
10
true
false
text
level2_question
Level 2 Chellenge: Add your Qantas Perth flight booking reference
full
true
^.*$
^[0-9]*\.[0-9]*$|^[0-9]+$
Field must be entered
true
false
checkbox
age_confirmation
I am 18 years of age or older and have read and understood the sweepstakes terms and conditions.
full
true
^.*$
^[0-9]*\.[0-9]*$|^[0-9]+$
Please confirm age
true
false