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PO BOX 5164
ALPHINGTON 3078
VICTORIA  Australia
Tel 61 3 9499 9100
Fax 61 3 9499 9122
Email Us

Application Form

Potential licensees must submit a pre-application form to the Centre's Manager for review.

User Information

Name : Email Address :

Business Name

Applicant's Details

Name:
Address:
Suburb:
Business Telephone:
Mobile :

Date Business Started

Date:

What is the Legal Structure of your Business

Have you Registered your Business with the relevant authorities?

 Australian Business Number (ABN)
 Local Government (eg Food Handling)
 Business Registration
 Other Licences

Describe your Business (What do you do? What do you sell?)

Do you have a written Business Plan?

Space Required (m2 Estimated Area)

Office:
Warehouse:

Special Requirements (eg. 3 Phase Power)

E-mail communication

Do you authorise us to contact you by email?
Yes No