QWaLC Membership Application | Queensland Water & Land Carers

Name of Person Completing this Application*

First Last

Legal Entity or Other Type*

Is your group endorsed as a deductible gift recipient (DGR)?

Yes

No

DGR Information can be found by clicking here

Is your group registered as a charity with the ACNC?

Yes

No

If you are unsure click here to find out.

Group Name:*

As it appears on your certification of incorporation

ABN*

If you don't know your ABN look it up at: https://abr.business.gov.au or don't have one just enter 11 zeros.

Group Name:*

Incorporated Association ID (if applicable)

If you don't know your IA identification look it up at: click here.

Enter the name of your auspice organisation (if applicable)

Which best describes your group:*

Briefly outline your group’s objectives and purpose (max 250 characters)*

In which LGA Area and NRM Region is your group located ?

Local Government Area*

Natural resource management region location:*

If you are unsure consult the map: https://qwalc.org.au/

Human Resources
Total number of Employees (F/T, P/T, Casual), Members, Volunteers and Total number of volunteer hours performed each month

Full-Time*

Part-Time*

Casual*

Members*

Volunteers*

Hours/Month*

Does your group auspice any unincorporated groups or sub-groups?*

No

Yes

List the organisations that you auspice below:

(List up to 5 groups)

Does your group work with any other natural resource management groups (e.g. landcare, bushcare, catchment management)?*

No

Yes

List the organisations that you work with below:

(List up to 5 groups)

Does your group have a copy of, and use, 'In Safe Hands' Toolkit from www.insafehandstoolkit.com.au?*

Yes

No

Using the space below please clearly describe the WH&S policies and procedures (or system) you use to manage risk*

Insurance coverage cannot be provided to Groups that do not have and implement risk management policies and procedures.

Does your group require insurance coverage?*

Yes

No

The following information is required for insurance purposes (annual totals)

Income*

Expenses*

Assets*

Liabilities*

Your Group's Address

(If you do not have a physical address you must enter a location that includes the suburb/town, postcode and state.)

Street Address Address Line 2 Suburb/Town State Post Code Country

Your Group's Primary Contact Person

First Name*

Last Name*

Position*

Phone*

Email*

Your Group's Secondary Contact Person

First Name*

Last Name*

Position*

Phone*

Email*

Your Group's Website, Email and Social Media Details

Website

Email*

Facebook

Instagram

Twitter

Please attach a copy of your organisation's constitution*

Accepted file types: pdf, doc, docx, Max. file size: 32 MB.

Please attach a copy of your organisation's certificate of incorporation*

Accepted file types: pdf, png, jpg, Max. file size: 32 MB.