Open to any individual or organisation offering an exercise program at low or no cost to the wider community. The emphasis here is that exercise participation is encouraged in a population that would normally find such exercise difficult to access. 

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* 1. Nominee Full Name or Business Name:

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* 2. Fitness Australia Registration Number (If unknown contact 1300 211 311) 

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* 3. Number of years registered with Fitness Australia

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* 4. Contact Information

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