WA Seniors Card - Business Partner - Expression of Interest

Interested Business to Complete

Page1 / 2

50% of survey complete.

The department is seeking interested business partners to provide a discount offer to WA Seniors Card members.

The department requests that interested business partners outline the following as part of the proposal to offer discounts to the WA Seniors Card program.

Question Title

* 1. Business details

Name of Legal Entity

Business Name

ACN (if a company)

ABN

Business Phone Number

Business Email Address

Business Website

Trade License (if applicable)

Question Title

* 2. Registered address / address of principal place of business

Address Line 1

Address Line 2

Suburb

State

Postcode

Question Title

* 3. Contact person

Name

Position Title

Telephone