Donation Application - The Barossa Co-op

Club or Organisation Details

Hidden

Date of application

Club or organisation name*

Barossa Co-op membership number of club/organisation*

To be eligible for sponsorship the club or organisation must be a member of Barossa Co-op

Primary function of club/organisation*

Sporting Club
Children/Youth Club
School
Special Interest Group
Community Support
Special Needs
Church Group

ABN

Registered for GST

Yes
No

Contact Details for Club or Organisation

Contact name*

First Last

Club or organisation address*

Address 1 Address 2 Town/City State Postcode

Contact phone number*

Email address*

* By submitting this application, your email address will be included in our marketing database and we will send you information we consider may be of interest to you. You may contact us at any time if you decide you no longer wish to receive this information.

Donation Details

Please provide a short description about your club/organisation/community group, including approximately how many people are involved.*

How will the Barossa Co-op donation be used to support your activity?*

Donation

By applying for Donation I agree to commit to the following requirements.

Commitment*

Donation up to $500 per application (one per year)
Member of Barossa Co-op
Non-profit, Charitable Organisation or Community Group

Sponsorship Type

Gift Card
Store Credit
Goods in Kind

Requested breakdown of Gift Cards (e.g. 10x $50)

Requested goods in kinds and approximate value

Requested store credit amount

Has the club or organisation been sponsored before?*

Yes
No

Years (please select all that apply)

Select All
2024
2023
2022
2021
2020

If there is any additional information you would like to add to support your application for donation, please do so here.

Not Compulsory

Further Supporting Documentation

Drop files here or

Max. file size: 1 MB.

Please attach any further documentation. E.g. photos, plans etc.

Comments

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