APPLICATION FOR SPACE - PRIVATE & CONFIDENTIAL
*** To assist with the processing of your application please fill in all sections of this form ***

Personal Particulars

Name:

Address:

Phone (Home):

  

Mobile:

  
Fax:    
Email:    

Details of Proposed Business Activity

Company Name:

Directors/Shareholders:

Date Business Registered:

ABN:

Phone Number:

Fax:

Email:

    

1.

Potential Markets for Product / Service
Indicate whether local, national, international:
Details of firm orders, contracts, market surveys undertaken:
Method of sale/distribution:
 

2.

Employment
Total estimated employees at start-up:
Additional employees in year 2:
 

3.

Training
What training will you arrange for yourself/staff within the first year?
What assistance do you need with training in the first year?
 

4.

Equipment
Specify major items used:
 

5.

 Material
Basic materials to be used:
Details of dangerous/flammable materials:
If so, details of safety & storage:
 

6.

Environmental Control
Details of any noxious effluent:
Details of any excessive noise levels:
 

7.

 References

Details of names, Occupation and contact details of persons who may be directly contacted for reference
Purposes (ie employer, supervisor, accountant, business associate. Reference should not be a relative or a friend):

1.  Name:      Phone:      Occupation:

2.  Name:      Phone:      Occupation:

3.  Name:      Phone:      Occupation:
 

8.

Additional Information

  PLEASE INSURE ALL INFORMATION IS CORRECT BEFORE SUBMITTING FORM