AGM Assistance Form

This form should be completed to request assistance to attend the Annual General Meeting held on 8-10 November 2023.

To make a claim the form must be submitted
BEFORE FRIDAY, 20 OCTOBER 2023.

Accommodation – AM-YAC members are to book and pay for their own accommodation. AMYAC
members that attend the meeting can arrange reimbursement for a maximum of four nights accommodation by providing a receipt to the Executive Office. The name on the receipt needs to match with the AMYAC member and the bank details to be reimbursed. Reimbursement will be processed within 3-4 working days of receiving receipt and bank account details.

Please note:
Once applications are approved, no changes will entered into.

Elderly or disabled will receive priority for accommodation assistance.

"*" indicates required fields

Section 1 – Your details

Name*

First Name Last Name

Mobile number*

Email address*

Where are you travelling from?*

Assistance Required

Assistance required

If option ticked please provide answers below.

Fuel – who will be driving (must have photo ID)?

Bus Ticket – concession number (if applicable):

Food – Confirm location below

Assistance Answers

Fuel – Drivers Name

Please state who will be driving (must have photo ID)?

Bus Ticket – Concession Number

Please state concession number (if applicable)

Food – Name of person collecting

It needs to be someone with photo ID

Food location

Where would you like to redeem your food?

Coober Pedy

Port Augusta

Section 3 – Declaration

41232

If you prefer you can download and email back the application form to trust@amyac.com.au

Download Pdf AGM Assistance Form

Antakirinja Matu-Yankunytjatjara Aboriginal Corporation

AGM Assistance Form

Section 1 – Your details

Assistance Required

Assistance Answers

Section 3 – Declaration