Please complete the questions below 

* 1. Organisation name

* 2. Address

* 3. Contact person

* 4. Email

* 5. Phone

* 6. Are you a registered Basketball Victoria Association?

* 7. If no what type of organisation are you? ie. Local Government, Aged Care facility, community group

* 8. If no are you aware of or have you contacted your local basketball association?

* 9. Do you have access to a suitable venue for delivery of the program? 

* 10. Venue details - Basketball Victoria will conduct an audit of unfamiliar venues to assess suitability

* 11. Do you have a group/s of people interested in participating in the program?

* 12. Do you have a staff/volunteer member to deliver the program?

* 13. How did you hear about Walking Basketball?

* 14. Please provide any additional relevant information about your organisation and interest in Walking Basketball