Online Form - Community Sponsorship Fund

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Note: Incomplete forms are kept for a period of 7 day(s), after this time the system will automatically delete your response.

Applicant Information

Name*

Date of birth*

Gender*

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Address

Street Address:

City:

State:

Post Code:

Country:

Phone Number*

Email*

Event Details

Event start date*

Event end date*

Who will you be representing?*

Upload any documentation regarding your selection to participate*

Max File Size: 10.00 MB
Allowed File Types: .avi, .doc, .docx, .gif, .jpeg, .jpg, .mov, .mp3, .mp4, .mpeg, .mpg, .pdf, .png, .ppt, .pptx, .xls, .xlsx

How will this donation assist you?*

Payment Details

Bank account details for electronic transfer of grant monies (if successful).

Account name*

BSB number*

Account number*

Bank name*

Declaration

I confirm that the information provided in this application is true and correct.

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Your Name*

Date*

For applicants under 18 years

Parent/guardian name*

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