Alpine Energy

Apply for sponsorship

Organisation / applicant name *

Postal address * Include suburb and post code

Physical address if different to above

Contact person's name *

Position held within the organisation

Phone number *

Email address *

Bank account details * Include bank name and account number

Are you GST registered?

If yes, what is your GST number?

Are you a registered charity?

If yes, what is your registration number?

Are you an incorporated society?

If yes, what is your incorporation society number?

How much do you require?

When is the money required?

Please provide a description of what the funds will be used for? *

What are the community objectives of the event/facility? *

How can we be involved in the event or with the facility? *

Other sponsorship currently applied for?

Other information Please attach any other information you think may be useful when considering your application for sponsorship.