New Date Survey

First and Last Name*

Company name*

*Please list the name used as reference when paying your stall holder fee.

Email*

Phone*

Name of Bank*

Account Name*

BSB*

Account Number*

Amount to be refunded*

I understand that my refund will be processed within 2 weeks of refund form submission.

A collaborative business community

Contact

secretary@gunnedah.org.au

PO Box 176,

Gunnedah NSW 2380

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Gunnedah and District Chamber of Commerce and Industry acknowledges the Traditional Owners of Country throughout Australia and recognises the Gamillaroi people, the Traditional Custodians of the land on which we operate and live, and pay our respects to Elders past, present and emerging.

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