Multicultural Community Partnerships
Application Form
Organisation Details
Please tell us a bit about your organisation
Name of Organisation
*
Select your state
*
Please Select
Victoria
New South Wales
Queensland
South Australia
Western Australia
Tasmania
Australian Capital Territory
Northern Territory
Postal Address
*
Address Line 1
Address Line 2
City / Suburb
State / Territory
Postcode
Organisation Number
*
Please enter a valid phone number.
Number of active members in the organisation
Please briefly tell us what your organisation does, and how the MHFA can best work with you
*
You can include information about your services
Please select your preferred membership options:
1 year partnership (membership fee of $100 per year)
3 year partnership (membership fee of $100 for year 1, and free for years 2 & 3)
Representative Details
Please nominate 2 individuals from your organisation who MHFA will direct all correspondence to during the partnership period
Representative 1 Name
*
First Name
Last Name
Representative 1 Designation/Position
*
Representative 1 Email
*
example@example.com
Representative 1 Number
*
Please enter a valid phone number.
Representative 2 Name
*
First Name
Last Name
Representative 2 Designation/Position
*
Representative 2 Email
*
example@example.com
Representative 2 Number
*
Please enter a valid phone number.
Please upload a copy of the following documents (where applicable): 1. Certificate of Incorporation; 2. Statement of Purposes of the organisation; 3. Rules of the organisation; and 4. Particulars of the Directors/Office Bearers of the organisation.
*
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