Online Form - Go Local First Registration » City of Kalgoorlie-Boulder

Business Name*

ABN*

Is your business home based?*

YesNo

Contact Name*

Position Title: (Are you the Business Owner or Manager)*

Business Address*

Postal Address*

Phone Number*

Email:*

Website

Do you sell products online?*

YesNo

Is your business on social media (Facebook or Instagram)?*

YesNo

How many employees do you have?*

How long have you owned the business?*

How long has your business been operating in Kalgoorlie Boulder?*

Which industry do you belong to?*

What is the biggest constraint your business is currently facing? (This could be the cost of doing business including utility costs, freight delays, staffing, stock availability or competition, lack of foot traffic…)*

If Other, please outline below:

Please outline below any suggestions or specific areas that the City can provide increased support that would be beneficial to your business:*

How did you hear about Go Local First?*

If Other, please outline below: