Organisation name *
Trading name (if applicable) *
ABN (if applicable)
ACN*
Address*
Contact person*
Contact person title*
Email*
Phone *
Website*
Size of organisation*
Are you located in the Perth Metro area?*
Are you a registered Not-For-Profit entity?*
Please provide information on your organisations mission, values and objectives*
How do you believe the ACT Community partner Program benefit your organisation?*
Are there any specific activities that your organisation is currently involved in that the Trust benefits could assist with?*
Are there any circumstances or arrangements that could be perceived to constitute an actual or potential conflict of interest with the Trust? *