Placeholder testing

First name

Last name

Member number

Phone number

Email address

Are you nominating yourself?

Yes

What is your relationship to the nominee?

Friend

Family

Staff

Neighbour

Other

Is the person aware of this nomination?

Yes

Your first name

Your last name

Your member number

Your phone number

Your email address

Please tell us about the person you are nominating and the difficult circumstances they are currently experiencing.

You can share as much as you feel comfortable. This information helps us understand the situation and assess support.

What would financial support from P&N Bank mean to this person or their family?

Please tell us if there a specific expense or need we can help with.

How urgent is the need for this person or family?

Within days

Within weeks

Within months

Please confirm the following statements are true:

The applicant and nominee is customer of P&N Bank
To the best of my knowledge the contribution granted won't be used for gambling, fundraising, a donation for another cause, for anything hazardous, dangerous or illegal, or that harms community people or animals.

I confirm these statements are true

By submitting your application for a grant, you agree to the program Terms & Conditions.

I agree

About

ABN 69 087 651 876 AFSL/Australian Credit Licence 240701