APPLY FOR ASSISTANCE

Apply for Assistance

The assistance we offer is totally co-ordinated by volunteers. Once we receive your application it will be entered into our database. When we are delivering to an area one of our team will be in touch to go through your application. As a volunteer organisation we know we cannot meet all your requirements. We encourage you to seek updated information and guidance from your states relevant bodies.
Reason for Assistance*

Drought AssistanceEmergency Fire AssistanceEmergency Flood Assistance
Full Name*

First NameLast Name
Spouse

First NameLast Name
Business / Trading Name
Property Name
Delivery Address - as per Google maps (No Property Names No Punctuation IE Commas or Full Stops) Please ensure you use your town/ locality and not the nearest big town. *****Incorrect addresses can delay assistance*

Street Address

Street Address

TownState

Postcode
Postcode*
Mobile Number*
Home Phone / Landline
Closest Town. This helps us plot you on a map so we can see where you are.*

State

Postcode
E-mail
Preferred Contact Method*
Your LGA*

State

Postcode
Are you a Primary Producer?*

Yes I am a registered Primary Producer who receives the majority of income from farming.I am a registered Primary Producer but farming is not my major income source.No I am not a registered Primary producer.
ABN number for Farm Business*
Property Identity Code - PIC (or similar)
Types of Assistance Requested **

Fodder
Number of Beef Cattle
Number of Dairy Cows
Number of Sheep
Number of Goats
Number of Horses
Other type of animals and number of animals
Do you have access for the following types of vehicles?*

12 metre flat bed truck19 metre semi-trailer27 metre B-DoubleNone of the above
What type of unloading equipment do you have?*

Hay spikesBale grabsForksNone of the aboveOther
What is the maximum height of your unloading equipment?*

No unloading equipement3 metres4.6 metresOther
Are you prepared to act as a Depot for yours and other properties in your vicinty?*
If you wish to received personal care packages, please include how many male adults, female adults and children (including male/female and ages of children) as this will help us with the packing of hampers should we be in a position to provide them.
Personal care package recipients
Verification*

I declare that the information provided above is true & correct, I agree that my information, if necessary, may be forwarded to one or more agencies for verification or for the purpose of providing assistance.
Disclaimer:*

I understand this is a request for assistance. While we would like to meet all requests, we are not able to guarantee to meet any or all, due to circumstances beyond our control, such as, lack of supply, lack of funds, and/or transport available to your area.
Should be Empty:

Apply for Assistance