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It would be very helpful if you could please complete this form.  It will assist in providing all the information required for us to forward your funding.  It will also afford you well-deserved publicity.

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      Please Note: If you weren’t able to include proof of payment (copy of receipts etc) with your application, it is very important that you supply them with this form so your funding can be paid. Payment can not occur until this information is received.

      Achieve your sporting goals

      Achieve your sporting goals

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      Gladstone, Queensland Australia 4680

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