Australian Country Choice Community Steakholder Event Pack application

Form
Section 1: About You
Organisation name*
ABN (if applicable)
Type of group*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Website/social media link (if applicable)
Contact name*

First NameLast Name
Contact position*
Contact Phone Number
Please enter a valid phone number.
Contact Email Address
example@example.com
Section 2: Event Details
Event name*
Please provide a description of your event.*
Where will the event take place?*
When will it take place?*
Section 3: Request Details
Will you require a marquee loan?
Will you require a perpetual shield?
Section 5: Declaration
I declare that the information provided in this application is true and accurate to the best of my knowledge at the time of submission. If any details change, I will contact Australian Country Choice (ACC) as soon as possible to provide updated information.

I confirm the funds will not be used for salaries, political or religious activities, or personal/commercial gain.

If successful, I agree to:
• Display an ACC-provided sign or digital tile acknowledging the grant
• Provide receipts and photos within 12 months of completion
• Allow ACC to use project details and photos in social media, newsletters, or reports

I understand that failure to provide receipts or acquittal information may affect eligibility for future grants.
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