Please complete the questions below 

Organisation name

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* 1. Organisation name

Address

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* 2. Address

Contact person

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* 3. Contact person

Email

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* 4. Email

Phone

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* 5. Phone

Are you a registered Basketball Victoria Association?

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* 6. Are you a registered Basketball Victoria Association?

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

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

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

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

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

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

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

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

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

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

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

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

How did you hear about Walking Basketball?

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* 13. How did you hear about Walking Basketball?

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

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

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