New Community Group Registration

To register the details of your Community Group, complete the details below.
Fields marked * are required.

* Community Group Name:
* Email Address:
ABN:
  Contact Details
* First Name:
* Surname:
Role:
* Phone Number:
Fax Number:
Mobile Phone Number:
* Email Address:
  Primary Address Details
* Address Title:
(for use on Invoices)
* Address 1:
(eg: 23 Colnol St)
Address 2 (optional):
* Lga:
* Suburb:
* Post Code:
* State:
  Membership Details
* Intended System Use:

  Lenders Only
* Please pay reimbursement to:
(Community Group/Organisation Name)
* Time Between Bookings:
(The minimum number of minutes between consecutive bookings)
* LGA's serviced by Organisation:
Select at least 1 LGA


* We Service
Eligibility requires at least two groups to be selected










Notes:
 
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Register my organisation's interest as a User.