* Denotes that the field is mandatory.
Organisation name *
Contact Person *
Contact Person's title (e.g. Mr, Ms, etc.) *
Contact Person's position (e.g. Chairman, President, etc.) *
Postal Address *
E-Mail Address *
Phone Number *
Mobile Phone
Is your organisation not-for-profit?
Is your organisation an incorporated legal entity or sponsored by an incorporated legal entity?
Does your organisation operate or provide services within the Toowoomba Region?
Does your organisation possess appropriate insurance to undertake projects and services in the Toowoomba Region?
Does your organisation adhere to sound workplace health and safety practices?
Is your organisation able to demonstrate financial viability?
What type of grant is your group most likely to be interested in and avail of? *
Please provide a short description of your grant application. *
Do you wish to be contacted?
What is the preferred contact number? *