Local Group Donation Request Form
At Beechworth Bakery, Community Matters. We’re giving back, supporting local and making a positive impact, because every voice and every neighbour counts.
Contact Details
To apply, we’ll need a few details about you. You’ll be our main contact for all updates and communications about your group’s application.
Contact Person
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Preferred Local Bakery
*
Please Select
Albury
Beechworth
Bright
Echuca
Bendigo
Healesville
Ballarat
Yackandandah
The Local Community Group or Local Community Project must serve the Local Area of the Preferred Bakery.
Group Details
Now for the important part! We’d love to learn a little about your local group and how Beechworth Bakery could make a difference.
Group Name
*
Group Type
*
Please Select
Health & Disability
Sport & Recreation
Youth Service/Organisation
Community Service
Education
Animals & Environment
Emergency Service
Support Service
Special Interest
Other
Please specify group type
*
Donation requested
*
Please Select
Bread
Cakes
Prize for Fundraising
Other
Please specify donation request
*
Date donation is requested for:
*
/
Day
/
Month
Year
Date
Size of your event or function (expected attendees)?
*
Please Select
0 - 10
11 - 50
51 - 100
101 - 200
200+
Tell us in 250 characters or less about your group and what your donation will be used for.
*
Website URL
Please provide a simple Group URL such as www.beechworthbakery.com.au
Facebook URL
Group Facebook URL
Instagram URL
Group Instagram URL
Please upload a flyer or further information here. Image must be a JPG or PDF. Less than 3MB (Optional).
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