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Form
Reusable Products Rebate Program
Reusable Products Rebate Program
Current
Applicant details
Rebate details
Complete
Full name
First name
Last name
Age
16 - 17
18 - 24
25 - 49
50+
Do you identify as?
Male
Female
Non-binary
Self described
Do you identify as Aboriginal or Torres Strait Islander?
Aboriginal
Torres Strait Islander
Both
Neither
Address
Address
Town
State
- Select -
VIC
NSW
QLD
SA
TAS
NT
ACT
WA
Post code
Email
Phone number
Please attach proof that you live in Golden Plains Shire by uploading an image one of the following documents
Current rates notice, current drivers licence, currently utility bill (within 3 months of purchase date).
One file only.
100 MB limit.
Allowed types: PDF, jpeg, PNG, doc, jpg.
