Sponsorship Application Form

Organisation details

Form Guidelines

Name

Charity no. (if applicable)

ABN (if applicable)

Registered address

Town/City

State/territory

Postcode

Purpose of the organisation

Summary of request:

Area of support (select all that are relevant)

Amount requested

Applicant details

Name

Position and organisation

Phone

Address

Town/City

State/territory

Postcode

Sponsorship information

Sponsorship amount requested

Date and duration of sponsorship request

Geographical impact/location

What level of sponsorship is Whitehaven Coal being asked to provide (e.g. primary sponsor, joint sponsor):

Which other sponsors are involved?

Please briefly outline why you are applying for a sponsorship from Whitehaven Coal.

Who is the target audience of your initiative? Who will benefit from this sponsorship?

How would your initiative benefit by Whitehaven Coal’s involvement?

How would Whitehaven Coal benefit from the association? Please include how Whitehaven Coal’s support would be promoted.

How would the sponsorship be measured and evaluated for effectiveness?

Please disclose any relationship with a local Council including which Council, and whether you are a Councillor, council candidate, council employee or otherwise associated.

Please share more information about your organisation if you wish.