Business listing application form

Complete all sections of the application form that apply to you business. Fields marked with * are required fields

Inclusion Criteria *
Applicants must meet the following criteria to be considered for inclusion in the directory. Please tick to indicate that you qualify.

The business is at least 50% Aboriginal and/or Torres Strait Islander owned The business is a commercial entity The business is registered in Victoria
Field is required

- How many staff do you employ including yourself? * (internal use only)
- Field is required
What year was your business established? * (internal use only)
Field is required
Organisational Structure * (internal use only)
Field is required
Ownership * (internal use only)
Field is required

Business name *
Field is required
Contact Name * (internal use only)
Field is required
Aboriginal Business Owner * (internal use only)
Field is required
Primary Address *
Field is required

Field is required

Victoria

Field is required
Region *
View the region map Hume Barwon South West Gippsland Loddon Malee Grampians Northern Melbourne Western Melbourne Southern Melbourne Eastern Melbourne
Field is required
Business Phone *
Field is required
Business Fax
Business Mobile
- Email Address * Please note: To reduce the risk of spam, your email address will not be visible to members of the public. However, they will be able to contact you using an online enquiry form.
- Field is required
Web/Social media site *
Hours of Operation
ABN *
Field is required
Registered Entity Name
Business/Product Overview * (Maximum 50 words)
Field is required and must not contain more than 50 words
Additional Information (Maximum 50 words)
Field must not contain more than 50 words
Association Membership eg. Kinaway, Supply Nation

Your business listing can have up to two images and a logo.

Only .gif, .jpg or .png files are allowed

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Koori Business Network