2020 CONTACT DETAILS & WEB PAGE INFORMATION & IMAGE FORM

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Check Out The Prospectus, click image to see full document.
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Please Select Your Level of Partnership* This field is required.Where applicable new business partners will be invoiced on submission of this form. In the case of existing Partners a Renewal tax invoice will be forwarded in January 2021.
Full Partner - $385 for 2 years commencing from date of payment - includes all partnership benefits as outlined in the Prospectus below.
Line Listing Partner on Regional Website - visitsouthernhighlands.com.au - FREE - includes website line listing, i.e. Business Name, Business Phone Number, Business Trading Hours and Business Address. NOTE this FREE listing option is not available to bookable product, e.g. accommodation, tours.
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Partnership PaymentsPlease select
Renewing Partner
New Partner
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Partnership Payment OptionsPlease select
Credit Card - please call the Southern Highlands Welcome Centre on 02 4871 2888 to make your payment.
In Person At the Southern Highlands Welcome Centre
Direct Deposit - details can be found on your tax invoice
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Direct Deposit PaymentsIMPORTANT INFORMATION - All boxes must be ticked
A copy of your payment remittance MUST be forwarded to Destination Southern Highlands when making your payment.
Please ensure that your reference number is included in your payment details - your reference number is your tax invoice number.
I acknowledge that if I do not forward a copy of my payment remittance and include my tax invoice number that my payment may not be able to be assigned to my partnership.
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Business Name:* This field is required.This is your trading name not your PTY LTD or Company name if different to your Trading Name
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Business Location Address* This field is required.This address will feature on your webpage
Street Address
Street Address Line 2
Town
Post Code
Please Select
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curacao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
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Business Postal AddressOnly complete if different to your location address
PO Box Number
Street Address (if applicable)
Town
Post Code
Please Select
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curacao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
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Business Phone Number* This field is required.This phone number will appear on your webpage
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Business Mobile Phone NumberThis phone number is optional
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Business E-mail* This field is required.This email address will appear on your webpage
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Business Website AddressThis website address will appear on your webpage
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Business Trading Hours* This field is required.Please include days and times.
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New Information, and Updates Including Business Category Selection/sTHIS INCLUDES ANY CURRENT CHANGES IN BUSINESS OPERATIONS IN LINE WITH COVID-19, eg. CHANGES TRADING HOURS, SERVICES OFFERED, ETC. If you are a new business and want to be have a business listing / page on www.visitsouthernhighlands.com.au you MUST complete this section by choosing YES. If you have NEW information and/or updates to previously provided information - please click YES, or If you have NO changes or updates click NO.
YESNO
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Tell Us Here About Any Operational Changese.g. if you are offering takeaways, tell us how they work, etc.
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Normal
Small
Ok
Ok
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You Can Upload New Menus, etc HERE
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
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Update or Add a New Point Of Difference:Please provide one sentence ( max 10-20 words) on what your Business' Point of Difference is.
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Update or Add a New Business DescriptionThis is where you provide a more detailed description of your business.
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Large
Normal
Small
Ok
Ok
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What categories would you like your page to appear in?Please indicate your category preferences here. NB: you can have different pages with different information and images specific to your pages, e.g. FOOD, GOLF. *NB: If you select bookable product categories, ie. Accommodation and/or Tours - additional information will be required and you will be contacted by Destination Southern Highlands.
ACCOMMODATION (not applicable for Line Listings) - (Department of Fair Trading Registration Number Will Be Required)
ARTS
ATTRACTIONS & ACTIVITIES
BEAUTY & HEALTH
BUSINESS SERVICES
CONFERENCES
CRICKET
CYCLING
EAT & DRINK
GARDENS
GOLF
HERITAGE
NATURE
RE-LOCATE
SHOPPING
TOURS (not applicable for Line Listings)
TRANSPORT
WEDDINGS
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Accommodation OperatorsALL Accommodation properties appearing on the regional website www.visitsouthernhighlands.com.au MUST by bookable by DSH - commission details can be found in the Terms & Conditions HERE. ALL accommodation properties will be required to provide their Department of Fair Trading registration number to Destination Southern Highalnds. ALL accommodation properties (not already appearing on www.visitsouthernhighlands.com.au, MUST have a site inspection by DSH prior to being uploaded onto www.visitsouthernhighlands.com.au. BOOK YOUR PROPERTY INSPECTION HERE
Yes
I understand that I will be required to provide specific information on property facilities, rooms, rates, cancellation policies and more, once the DSH site inspection has been carried out.
I understand that I will be required to provide specific information on property facilities, rooms, rates, cancellation policies and more, once the DSH site inspection has been carried out.
Yes
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Eat & Drink Sub CategoriesPlease indicate your business category preference/s here. You can select up to three (3) categories if applicable.
Breweries
Cafes
Cellar Doors
Cider
Distilleries
Farm Gates
Liquor Stores
Local Produce
Markets
Pubs
Restaurants
Tours
Wine Sales
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Shopping Sub CategoriesPlease indicate your business category preference/s here. You can select up to three (3) categories if applicable.
Antiques
Art
Bookshops
Farm Gates
Fashion & Clothing
Furniture
Gifts
Homewares
Jewellery
Local Produce
Markets
Shopping Centres, Supermarkets
Sports & Outdoors
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Wedding Sub CategoriesPlease indicate your business category preference/s here. You can select up to three (3) categories if applicable.
Beverage / Wine Producer
Cakes
Car Hire
Catering
Celebrants
Child Minding
Churches
Entertainment
Florists
Hair & Beauty
Hire & Rentals
Photographers
Printers
Transport
Venues
Wedding Planners
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Conference Sub CategoriesPlease indicate your business category preference/s here. You can select up to three (3) categories if applicable.
Catering
Conference Organisers
Entertainment
Hire & Rental
Off Site Programs
Venues
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Upload New Images and / or Your LogoIf you have new images and/or updated to previously provided images/logo - please click YES. OR If you have no changes or updates click NO.
YESNO
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Does your company have a logo? If so, please attach a high res version below (min 300dpi) and a min 1mb in size.
Drag and drop files here
Select files to upload
Min. file size1.0MB, Max. file size: 10.0MB
Cancelof
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Images For Your WebpageThis is where you can upload up to 10 different images to be used on your webpage. They need to be high res (min 300dpi) and a min 1mb in size. This will allow DSH to use your images on other promotional platforms, including print media and visitnsw website as required. Please note that by supplying images here you are providing DSH with permission to use these images for other promotional purposes as required.
Drag and drop files here
Select files to upload
Min. file size1.0MB, Max. file size: 10.0MB
Cancelof
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Primary Business Contact Name* This field is required.
First Name
Last Name
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Primary Business Contact Details* This field is required.
Please enter your email
Please enter your phone number
Please enter your position title
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Additional Business Contact Details* This field is required.Do you have additional business contacts that your would like to advise?
YESNO
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Additional Business ContactsDoes your business have additional contacts, e.g. marketing manager, GM, etc. If so tell us here.
No Additional Contacts
One Additional Contact
Two Additional Contacts
Three Additional Contacts
Four Additional Contacts
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Additional Business Contact #1 Details
Full Name
Email Address
Phone Number
Position Title
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Additional Business Contact #2 Details
Full Name
Email Address
Phone Number
Position Title
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Additional Business Contact #3 Details
Full Name
Email Address
Phone Number
Position Title
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Additional Business Contact #4 Details
Full Name
Email Address
Phone Number
Position Title
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Are You Happy For DSH To Share Your Business Contact Information With Other DSH Business Contacts?* This field is required.
YESNO
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Is Your Business A Member With Other Local Business Associations?
NO
Southern Highlands Chamber of Commerce & Industry (SHCCI)
Moss Vale Rural Chamber of Commerce
Robertson Chamber of Commerce
Southern Highlands Food & Wine Association
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Terms and Conditions* This field is required.
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Business Signatory Details* This field is required.
Name of business representative signing on behalf of the business - this MUST be a person's name and not the business name.
Business representative position
Business representative email address
Business representative contact phone number
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Business Contact Signature* This field is required.
Clear
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Please upload your Public Liability Insurance - Certificate of Currency
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
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Please upload your relevant Wingecarribee Shire Council approvals, etc.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
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IMPORTANT INFORMATION

For Destination Southern Highlands to receive your completed form YOU MUST click the SUBMIT button.

You will then receive a confirmation of receipt!
Should be Empty:

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