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Please note: These Packages are being released in stages and in limited numbers. Register your interest now so that you don’t miss out! * Terms and conditions apply.
Title:* First Name:* Middle Name:
Last Name:*
Household Name:*(eg P.Smith &T. Anderson or Gates-Jones )
Home Phone Number:* Mobile Phone Number:
Work Phone Number: Email Address:*
Postal Address: Street:* City:* Post Code:* Municipality:* Select your Shire Buloke Campaspe Central Goldfields Shire City of Ballarat City of Greater Bendigo Ganawarra Shire Hepburn Shire Loddon Shire Macedon Ranges Shire Mount Alexander Shire Northern Grampians Shire Pyrenees Shire Rural City of Ararat Rural City of Swan Hill
Residential Address (if different from Postal Address) Street: City: Postcode:
Privacy Statement Your privacy is important to us. Sustainable Regional Australia Pty Ltd (ACN 114 664 050), trading as ZC02e, is collecting the personal information on this form so that we can to respond to your enquiry regarding the Central Victoria Solar City Project and to provide you with further information on the various product trials. Your personal information may be shared with members of the Central Victoria Solar City Project consortium and may also be shared with the related companies, contractors, agents and suppliers of consortium members (including IT providers, financial institutions, marketing and communications agencies, call centres, printers, mailing houses, debt collection agencies and external business advisors) where required for these express purposes, and also for any other purpose you have consented to or as authorised by law. As you progress through the different stages of Central Victoria Solar City Project trials, your personal information may be used by ZC02e or other consortium members in order for us to perform further tasks related to the product trials, including the provision of further information (by telephone or email) or to supply the actual products to you. If you do not provide the personal information requested, you may not participate in the Central Victoria Solar City Project. If you wish to access or correct the personal information ZC02e holds about you, please contact us on (03) 5479 1900. For further information about the collection and handling of your personal information, please refer to our Privacy Policy which is available at www.centralvictoriasolarcity.com.au.
