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Section 1 of 2 - Your Organisation

Welcome to the 2012 NSW Seniors Week online Submit Your Event form.

The event information you provide will be included in the 2012 event listings on the NSW Seniors Week website, however opportunities to be listed in the official NSW Seniors Week Event Program are now closed.

To be eligible, your NSW Seniors Week event or activity must:

be open to the public
be free or specially discounted
be held between Sunday 18 March - Sunday 25 March, 2012
not promote religious activities or encourage gambling (eg. bingo)

Applications cannot be saved. Prepare your responses before completing this form. Details required include:

Your organisation details - eg. contact details, ABN, a copy of your public liability insurance, media liaison, local council
Your event details - eg. event title, date, time, description, cost
Your event venue details - eg. location, accessibility, catering, transport, useful information

You will receive an email confirmation once your details have been submitted. If you have more than one NSW Seniors Week Event to submit, you will be able to add another event at the end of completing this form.

If you are experiencing technical issues please copy the error and email it to swfeedback@facs.nsw.gov.au or call 02 8270 2444.

* Asterisks indicate a mandatory field

1. Your Organisation

Your Organisation

Name of organisation*

ABN*

Website*

Facebook Page

Which of the following best describes your organisation?*

2. Street Address

Street Address

Address line 1*

Address line 2

Suburb*

State*

Postcode*

What is the local council?*

3. Postal Address

Postal Address

Same as street address

Address line 1*

Address line 2

Suburb*

State*

Postcode*

4. Main Contact

Contact person for this application Title

Other

First Name*

Surname*

Position Title*

Email*

Telephone (daytime)*

Mobile

5. Secondary Contact

Secondary Contact Title

Other

First Name*

Surname*

Position Title*

Email*

Telephone (daytime)*

6. Marketing/media Contact

Marketing/media Contact

Does your organisation have a marketing/media person? If so, please provide their contact details

Title

Other

First Name*

Surname*

Position Title*

Email*

Telephone (daytime)*

What is the local radio station/newspaper/television station?*

Additional Information

Does your organisation have Public Liability Insurance?*

Attach a copy of the Public Liability Insurance certificate*

Important Note

A copy of a Public Liability Insurance certificate must be cited by ADHC to proceed with this application.

How would you prefer to complete this form in future?

Online
Paper-based