Discounted Charity Rate Application Form

DISCOUNTED RATE FOR CHARITIES

APPLICATION FORM

Thank you for your interest in applying for the 10% Charity discount rate for our virtual training courses. Please complete the following details and we will be in contact shortly.

For further inquiries, please contact training@engagementinstitute.org.au

All fields marked with * are required and must be completed.

SECTION 1: ORGANISATION DETAILS
(The organisation's details will appear on the tax invoice and receipt, should the application be approved).
Organisation*
Country *
ABN*
ACNC Registration Number*
NZBN*
Charity Registration Number*
Address*

Street Address

Street Address Line 2

City / SuburbState / Region

Postcode
Website*
Name*

Contact Person First NameContact Person Last Name
Contact Person Email*
example@example.com

SECTION 2: PARTICIPANT DETAILS
Participant One:
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Course Name and Date/s - Please list all the courses and dates you would like to be registered for
Participant Two:
Name

First NameLast Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Course Name and Date/s - Please list all the courses and dates you would like to be registered for
Participant Three:
Name

First NameLast Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Course Name and Date/s - Please list all the courses and dates you would like to be registered for
If you have more than 3 participants you would like to register for the Charity Discount Rate, please send the details through to training@engagementinstitute.org.au

Terms & Conditions
Declaration

The Engagement Institute respects your privacy and the confidentiality and security of personal information provided by you to us. The information provided by you to the Engagement Institute on this Application form will be used by the Engagement Institute for the purposes of communicating with you in relation to this Application Form in accordance with our Privacy Collection Statement. Our Privacy Policy contains information about how you may access your personal information and seek correction of such information.
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