<p>Garage Sale Trail 2017 REGISTRATION FORM</p><p>APPLICANT DETAILS Name of local government: </p><p>Street address: </p><p>Postal address (if different from above): </p><p>Local government website address / Facebook page (please insert link if available):</p><p>CONTACT PERSON</p><p>First name: Last name: </p><p>Position: </p><p>Email: </p><p>Phone / Mobile: </p><p>DECLARATION</p><p>I, (name) …………………………….…..………. (position) …………………..………..…………………. of </p><p>(organisation) …………………………...... declare that the information given in the Garage Sale Trail registration form and all attached documents is complete and correct to the best of my knowledge, information and belief.</p><p>Authorised officer Signature</p><p>Name</p><p>Date</p><p>Witnessed by Signature</p><p>Name</p><p>Date</p><p>Please provide evidence of your local government registration with Garage Sale Trail. Attach evidence if available. Date registered with Garage Sale Trail: ______/______/______</p><p>Evidence provided: YES NO</p><p>Attachments: [list any attachments included in this application form:</p><p>Has your local government paid its participation fee? YES NO If yes, please provide evidence: If not, please advise estimated payment date: Please advise date when evidence will be provided to Waste Authority: _____/______/_____</p><p>Please nominate staff contact details from two departments in the local government that will be involved in organising Garage Sale Trail activities and community engagement support: Name: ______Position: ______Department ______</p><p>Name: ______Position: ______Department ______</p><p>Please confirm that you will acquit the grant online. YES NO</p><p>PLEASE SUBMIT YOUR REGISTRATION BY 31 MAY 2017</p><p>Registration must be electronic and lodged through our website.</p><p> www.wasteauthority.wa.gov.au/gst</p><p>Your registration will be confirmed on screen and by automated email. If you are experiencing problems, please email [email protected] or call 6467 5313</p>