Coles Manjimup Community Club Card Application Form

“Coles Manjimup Community Club Card” Application Form

Coles is at the heart of local communities around Australia and we’re committed to supporting local charities, groups and organisations. To be involved with the Coles Manjimup Community Club card simply have your Authorised club representative fill in the below form and submit it via email to

Organisation details

Organisation Name: __

Address: ______

Phone: Email: ______

Website : ______

Authorised Club Contact: ____________

Position: ______

Phone: Email: ______


Please explain the purpose of your Club/Association/Group:




Number of participants/members: ______

Additional information: ______


Application Checklist:

Application form ¨

Club Logo ¨

Certificate of incorporation ¨

Please note that Coles does not support the following: Political groups or activist organisations; Capital fundraising; Local councils; Endowment and trust funds; Fundraising for overseas appeals, charities and travel.

Unfortunately, for this specific program Primary Schools, High schools and Kindergartens are not eligible to participate.

Please note: Gift cards redemptions will be by way of a Coles Gift Card; our gift cards can be used in our national Coles supermarket stores (excluding the purchase of alcohol, tobacco, Gift cards and fuel).