Enquiries: andy stringer



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Enquiries: andy stringer

Ph: (03) 5995 9520

Email: astringer@casey.vic.gov.au

Web: www.casey.vic.gov.au







Application Form

PA System Donation





Office use only

Received Date:


Applicant’s details


Applicant Group Name ABN (If registered)

     




     

Contact Person Title (eg Secretary/President)

     




     

Address

     

Suburb Postcode

     




     

Telephone (BH) Mobile Email (all email correspondence will sent to this email)

     




     




     



Please demonstrate how your group/organisation will use the equipment for your projects/activities:








How often do you envisage the equipment being used within the next 12 months?








Do you have the resources to purchase the additional equipment for the unit to be functional (approx. $500.00)? If no, how do you propose to secure them?









Do you have access to someone with the technical knowledge to operate the equipment?





Please submit the application to Andy Stringer at the City of Casey by 9:00am 13 November 2014 via email to astringer@casey.vic.gov.au or by mail to: Andy Stringer PO Box 1000 Magid Drive Narre Warren 3805.



Privacy

Your personal information will be handled in accordance with the Information Privacy Act 2000 and used for the specified purpose. You can access your personal information by contacting Council’s Privacy Officer on 9705 5200.





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