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Regional Development Australia Barossa Gawler Light Adelaide Plains
We identify local challenges and economic opportunities.
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Inaugural Business Survey – Prize Draw Terms and Conditions
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Home
About
About Us
Staff Members
Board Members
Board Members Portal (Restricted)
Reports & Regional Data
Partners
Barossa Council
Adelaide Plains Council
Town of Gawler
Light Regional Council
Pay Online
News & Events
News
Events
Empowered Leaders Program
Empowered Committees Program
Jobs & Skills
Barossa Campus
Careers in Our Region
Business
Apply for a Grant
Grow a Business
Business Fundamentals Program
B2B Support Program
Reports & Data
Reports & Regional Data
Investment
Apply for a Grant
Invest in SA
Investment Support
Reports & Regional Data
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Contact Us
Contact Us
Inaugural Business Survey – Prize Draw Terms and Conditions
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B2B Subsidy Application
"
*
" indicates required fields
Please complete the following application.
Applicant's Business Name
*
ABN
*
Applicant's Name
*
First
Last
Position
*
Address
Street Address
Town/Suburb
Postcode
Phone (W)
Phone (M)
*
Email
*
Website Address / Domain Name
*
Business Type
*
Company
Partnership
Sole Trader
Trust
Other
Trustee Details
Other Business Type
FEE SUBSIDY QUALIFICATION CRITERIA:
Your Turnover Range
*
Up to $100,000
$100,000 - $250,000k
$250,000 - $500,000
Greater than $500,000
Number of Employees
*
Have you accessed any other programs through RDA BGLAP which involved the provision of a fee subsidy or financial support in any other way? If so, which?
*
Yes
No
If Yes - Please advise:
*
Which of the following Council areas is the business located in?
*
The Barossa Council
The Town of Gawler
Light Regional Council
Adelaide Plains Council
Please detail the services or help you are seeking
*
Add
Remove
Comments or Questions
Warranty and Acknowledgement
I, the Applicant and owner of the above referenced business, warrant that the information provided above is true and correct to the best of my knowledge. I agree for the information relating to the above referenced business to be provided to RDA Barossa Inc together with a brief summary of recommendations prepared by the Service Provider in order that the provision of services by the Service Provider be considered for the fee subsidy by RDA Barossa Inc for a maximum of 2 hours work. I acknowledge that: • RDA Barossa Inc will hold, treat and maintain the confidentiality of the information provided by the Applicant acknowledging it to be valuable property of the Applicant’s; • RDA Barossa Inc will use the Applicant’s information for the sole purpose of assessing whether the Applicant qualifies for the provision of the fee subsidy and shall not use the Applicant’s information for any other purpose without the prior written consent of the Applicant; and • the provision of the fee subsidy to the Applicant is at the sole discretion of RDA Barossa Inc.
Consent
*
I agree to the Terms and Conditions set out in this form.
(Following the submission of this form, you / the Applicant will be invoiced the consultancy fee by RDA Barossa Inc (unless other arrangements have be made). On payment of the invoice, the B2B Service Provider(s) will be notified so that they can proceed with the provision of their services to you / the Applicant.)
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