Light Rigid (LR) Driving project

Application for Use of Community LR Driver

Company Name:*

First Name:*

Last Name:*

Address:*

Town/City:*

Postcode:*

Email:*

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Phone:*

Date for Booking:*

No. of Passengers:*

Starting Address:*

Pick-up time:*

Destination:*

Return Address (if different from starting address):

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IMPORTANT: Please note that all bookings must be recieved two weeks prior to the required date. Please email volunteering@sectorconnect.org.au or fax 46485944 a copy of Public Liability and Volunteer Insurance.