FundAssist

Fund Assist Associate Expression of Interest Form

Part 1 - Business Details

Part 2 - Contact Person Details

Contact Name:	*
Contact Telephone:	* Please enter number without spaces
Contact Facsimile:	* Please enter number without spaces
Contact Email:	*
Preferred method of contact (write 'Any' if you have no preference)

Part 3 - Business Capability
Please provide information about the firm's area of specialisation:

Broad Area / Field	Brief Description of Services

Provide details about at least 5 projects that the firm has completed. Try to provide information that illustrates the range of projects the firm has undertaken.
Project Name/Title	Client	Year Completed	Brief Description
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Does the firm provide any funding application/submission services?

Does the firm work with any private company that provides funding application/submission services? (If 'yes', please supply the name of the firm)

If YES, enter firm name here

Note any other information about your firm.