#SEAPartner application form
Company Details
Company name:
*
ABN:
*
Primary Business Activity:
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
-
Area Code
Phone Number
Website
*
Partnership Category
Please check the appropriate option
Large Corporate Partnership ($8,400 + GST)
Small Corporate Partnership ($5,500 + GST)
Non-for-profit (negotiable)
Primary Contact
Name
*
First Name
Last Name
Position
*
Phone Number
*
-
Area Code
Phone Number
Monile Number
*
-
Area Code
Phone Number
Email
*
example@example.com
Signature
The applicant agrees to the terms and conditions of the partnership as outlined in the Partnership Agreement set out by the Sports Environment Alliance (SEA).
Signature
*
Date
*
-
Day
-
Month
Year
Date
Name and position
*
Representatives
Corporate Partnership allows a primary contact to nominate an additional two (for large corporates) or one (for small corporates) individuals to be included as named partner representatives. Please add the contact details for these individuals below.
Individual Contact 2 - (Large and Small Corporate)
First Name
Last Name
Position
Phone Number
-
Area Code
Phone Number
Email
example@example.com
Individual Contact 3 - (Large Corporate)
First Name
Last Name
Position
Phone Number
-
Area Code
Phone Number
Email
example@example.com
Submit
Should be Empty: