Community Barbeque Rebate Application

Community Barbeque Rebate Application
Team Name
Part A: Registration
The program is designed to build trust and connection in communities across the City of Armadale. Please read the Community BBQ Rebate Guidelines before completing this form.
Name*

Given NameFamily Name
Phone Number*
Email*
example@example.com
Residential Address*
Activity Date

DayMonthYear
Activity Time*
Activity Location*
Number of expected participants*
Would you like more information about becoming a Community Champion?*

YesNo
Declaration*

I have read and agree to the Community BBQ Rebate Guidelines.I confirm this event is for people in my street/neighbourhood.I confirm this activity is in a public area.I understand the rebate will not cover the purchase of alcohol.
Signature*

Clear
Date

DayMonthYear
For more information or to discuss your activity please contact the Community Development team on 08 9394 5000.
Should be Empty: