Balirt Biik Kiyiyt (Meeting) Request Form
Request a meeting with the Balirt Biik (Strong Country) Team
Project Name / Location
*
Organisation (making the request)
*
Main Contact Full Name
*
First Name
Last Name
Main Contact Number
*
Please enter a valid phone number.
Format: 0000 000 000.
Main Contact Email Address
*
example@example.com
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Booking Details
Booking Type
*
Please Select
Balirt Biik (Strong Country) Manager - Shani Blyth
Balirt Biik (Strong Country) Conservation Work
Balirt Biik (Strong Country) Fire Meeting / Site Inspection
Balirt Biik (Strong Country) Pest & Wildlife Meeting
Balirt Biik (Strong Country) Water Team Meeting
Balirt Biik (Strong Country) Sea Country Meeting
Language Inception Meeting
Renewables & Climate Change Meeting
EPA Meeting
1hr Meeting - $1,500 ex GST
Conservation Team
*
Central Team
Eastern Team
Western Team
Additional Information (what is the meeting regarding)
*
Preferred Meeting Date & Time (Please list THREE options)
*
Is this meeting Online or In Person?
*
Online
In Person
In Person Meeting Address
*
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Billing Details
Cost: $1,500 ex GST
Organisation Name
*
ABN / ACN
*
Billing Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Contact Person
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: 0000 000 000.
Purchase Order Number (if applicable)
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Agreement
I, as the Authorised Officer / Billing Recipient, warrant that the details provided on this booking form are true, correct, and accurate, and confirm that the submission of this booking form is acceptance of all terms and conditions associated with the booking including terms of trade and any applicable cancelation fees.
*
I agree with the above statement
Signature
*
Date
*
-
Day
-
Month
Year
Date
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