Business Planning & Professional Services Grant - Gumala

GUMALA ABORIGINAL CORPORATION
Business Development
Business Planning & Professional Services Grant
Program
New Business
Application Form 4.1
NAME:
ADDRESS:
DOB:
FAX:
_____ / _____ / _____ MOBILE: HOME:
EMAIL:
Language Group: Banyjima Innawonga Nyiyaparli
Purpose of the Grant
CHECKLIST: (This section must be completed)
Business Plan or detailed capability statement or details of other preliminary
planning work already undertaken.
Plus any two or more of the following:
License or permit application forms, correspondence or simliar documents clearly
verifying the intent to engage in a business enterprise.
Copy of pending work contracts or expression of interest from potential
customers
Letter from accountant or business advisor confirming the intention to establish a
business enterprise and the steps undertaken to date.
ABN or other business registration document.
Other documnetation/verification as requested by the Business Development
Manager.
Have you applied for any assistance with other organisations in regards to this application
(e.g IBN, IBA, Manyrivers etc.)
Please Tick
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Yes □
No □
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INFORMATION ON COSTS:
$
$
$
$
$
$
$
$
TOTAL $
SUPPLIER DETAILS:
COMPANY NAME PHONE # FAX #
Signature:
Date:
Office Use Only
Date received:
By:
HEAD OFFICE - 1 Stadium Road Tom Price, WA 6751
POSTAL ADDRESS - PO Box 3167, East Perth WA 6892
PHONE - 1800 486 252 (1800 GUMALA) FAX - 9219 4555 EMAIL - gac@gumala.com.au
Disclaimer: Application approvals are subject to funding being provided to GAC by the Trustee, and funds being available from the relevant GGF Income
Utilisation Category. Please note that Gumala Investments Pty Ltd (Trustee of the GGF) only provides funding to GAC Members who are Beneficiaries on its
register.
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