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* 1. What is your organisation's name?

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* 2. Who should we contact at your organisation if we need to follow up?

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* 3. Please confirm your organisation endorses the Healthy, Regenerative and Just as a framework for a national strategy on climate, health and wellbeing for Australia (and gives permission for your organisation's name and logo to be displayed as a supporter).

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* 4. Please upload your organisation's logo as an image file (jpg, png, gif)

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.
Choose File

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* 5. Do you have any questions or comments?

Thanks so much for your support!

T