Cockburn Volunteer Discount Card Registration Form

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Print Form

Cockburn Volunteer Discount Card Registration Form

All fields are required except where indicated

Organisation details:

 
Please supply an ABN or statement by supplier:
 
 

Address

EG Landline or Mobile
Please upload a members list or complete the volunteer list below.
To add a volunteer please enter the name of the volunteer and click the 'add volunteer' button.

1. Eligibility

To be eligible to request to City of Cockburn Volunteer Discount Cards (the ‘Cards’), the group, organisation or association (‘the Card Requestor’) must:

  • be registered with the Cockburn Volunteer Centre
  • be operating within the City of Cockburn district
  • have benevolent purposes or provide support to the Cockburn community
  • be aligned with the City of Cockburn’s values
  • not be subject to current enforcement action under a City of Cockburn local law or other law for which the City of Cockburn has responsibility for enforcing.

The following Card Requestors are not eligible to request Cards:

  • Companies operating for-profit
  • Churches; Religious Institutions
  • Political parties or members of Parliament (or their offices).

Requests for Cards can only be made by completing this application form.

The City of Cockburn may, in its sole discretion, accept or decline requests for Cards.

2. Responsibilities of Card Requestors

Card Requestors must:

  • only request Cards for their current volunteers, who have volunteered for more than six (6) months
  • not provide Cards to persons who are not current volunteers
  • only provide a Card to the person named on the Card.

3. Agreement term

On approval by the City of Cockburn of a Card Requestor to receive Cards, an Agreement between the City of Cockburn and the Card Requestor is created comprising of the Conditions outlined on this web page.

The Agreement commences when the City of Cockburn notifies a Card Requestor that their application has been approved.

The Agreement continues until it is terminated by either the City of Cockburn or the Card Requestor, or the Card Requestor completes another Application Form.

4. Termination

The City of Cockburn may, at its sole discretion, terminate the Agreement by written notice to the contact person nominated on the Application Form.

The Card Requestor may terminate the Agreement by written notice to [email protected]

On Termination, the Card Requestor must take all reasonable efforts to reclaim issued Cards from its volunteers and provide them, and any spare Cards in their possession, to the City of Cockburn within 30 days.

5. Changes to Conditions

The City of Cockburn may amend, vary or modify these Conditions at any time, without notice.

The amended Conditions take effect from the time they are changed on this web page.

A Card Requestor’s continued involvement in this Program constitutes consent to be bound by the Conditions as varied.

Related Pages

Contact

Address

City of Cockburn
Whadjuk Boodjar
9 Coleville Crescent,
Spearwood 6163

PO Box 1215, Bibra Lake DC,
Western Australia, 6965

Office opening hours:
8.30am to 4.30pm
Monday to Friday (excluding public holidays)

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Cockburn Nyungar moort Beeliar boodja-k kaadadjiny. Koora, yeyi, benang baalap nidja boodja-k kaaradjiny.
Ngalak kaditj boodjar kep wer kaadidjiny kalyakool yoodaniny, wer koora wer yeyi ngalak Birdiya koota-djinanginy.

The City of Cockburn acknowledges the Nyungar people of Beeliar Boodjar. Long ago, now and in the future they care for Country.
We acknowledge a continuing connection to Land, Waters and Culture and pay our respects to Elders, past and present.