Your Information

This application form is for South Australia only
This is the LGA in which your farm is located, or in which you work
*
This is required for Government Reporting
This is the occupation from which you derive your primary income
Please upload a utility bill or SA driver's licence showing your name and current address.
Applicant's Bank Details
Please provide your bank details so that we can transfer to you the $2,000 'cash' portion of the drought funding
This is the 6 digit number that identifies your bank and branch

Information for payment to local business/es
Vinnies can pay $1,000 on your behalf to a maximum of two local businesses (this may be to pay an account, or to achieve credit)
Local Business 1
This could be a scanned copy or photograph of the entire invoice/bill
Local Business 2
This could be a scanned copy or photograph of the entire invoice/bill
Yes
No
We can provide you with additional information about how to seek non-financial assistance

Declaration

Yes
Yes
Please include any comments or additional information that will assist us to process your application