* Mandatory Field

Application for Rate Rebate
Contact Details
Community Group*
Name*
Position*
Contact Number*
Email
Application
Lease*

Name of Facility

Property Address*
Percentage of general rate rebate*
Reasons why your community group should be a granted a rate rebate*

Eg. As per Lease Agreement, Non-profit group

If you see this, leave this form field blank.

Send a copy of the submitted form to this email address.

PO Box 94
Melrose SA 5483
Tel: 08 8666 2014| Fax: 08 8666 2169