Please ensure your organisation meets the criteria prior to completing this form
Mandatory fields are marked with a *
Your Details:
Title *
Name of Organisation *
Contact Name *
Email Address *
Position/Designation
Contact Phone Number (Daytime)
Contact Phone Number ( Mobile or evening)
Please provide a brief description of the organisations work in the community. *
Please provide a description of how your volunteers use vehicles in their work for the organisation. *
Please select the area(s) the organisation operates in: *
Do you receive Government funding *
If yes, please provide approximate percentage of the organisations costs covered by the Government funding:
How many volunteers does your organisation have?* *
Of those volunteers how many use vehicles in their work for your organisation? * *
Are these vehicles provided by the volunteers? *
What is the average distance in kilometres your volunteer drivers would drive in a month (each)?* *
Please provide the address you would like the vouchers sent to should your application be successful, please note this must be a physical address not a PO Box
Street Number
Street Name *
Suburb *
City *
Would you like to receive future communications about this programme from BP? *
Terms and Conditions
