2023-2024 Annual Donations Payment Details Applicant Details Name of Organisation* - required Name of Contact Person* - required Position in Organisation* - required Street Address* - required Suburb* - required State* - required Select ACT NSW NT QLD SA TAS VIC WA Postcode* - required Is this your postal address?* - required Yes No Postal Address Postal Address* - required Suburb* - required State* - required Select ACT NSW NT QLD SA TAS VIC WA Postcode* - required Contact Number* - required Email Address* - required Do you consent to Tamworth Regional Council updating their records with the information provided above?* - required Select Yes No Do you wish to receive your payment by EFT?* - required Yes No (Please note, if you select 'no' a cheque will be issued to your organsiation) Bank Details Name of Banking Institution* - required Account Name* - required BSB* - required Account Number* - required I certify that the information provided in this application is correct to the best of my knowledge.* - required I certify that I am authorised to provide these banking details on behalf of the abovementioned organisation. Privacy Statement Personal information supplied to or collected by Tamworth Regional Council will only be stored and processed by Council for lawful purposes directly related to the functions and activities of Council. Any personal information supplied will only be disclosed to a third party for the purpose of performing a lawful function or activity and for no other purpose. Disclosure of personal information to a third party will be in accordance with Tamworth Regional Council's Privacy Management Plan (PDF 331.7KB). Mandatory field(s) marked with *