Queensland Hub Exchange of Expertise and Learning Initiative -Expression of Interest Form Survey

Thank you for your interest in the initiative, which closes November 7th.

We recommend that you first complete your responses in the Word version, as you will not be able to save a draft in this format.

If you have any problems completing this form, please contact Sophie Morson on 0411 374 664 or email sophie.morson@aracy.org.au

When you reach the end of the form, you can request to receive a copy of your responses via email.

Applicant and Hub Details

1.Please list the contact person for this application(Required.)

Name:

Position title:

Email address:

Phone number:

2.Please provide details of your hub
(or organisation if your hub is in establishment).

If a question doesn't apply, please write N/A in the box so you can move on to the next question.(Required.)

Residential address of the hub:

Suburb:

Postcode:

ABN of the hub/organisation:

Have you registered for GST (Y/N)

Hub website domain (if applicable):

Year hub was established (if applicable):

Number of staff directly employed by hub (if applicable):

Number of volunteers engaged in the hub (if applicable):

4.Is your hub?(Required.)

Established

Under development

In planning stage