Connect program registration form

The Department of Industry invite NSW businesses to register to participate in the Connect program.

The Connect program aims to strengthen engagement and collaboration across industries in NSW, and facilitate networking opportunities with other businesses.

Important information about this form

You cannot save a draft of this form and access it later — you will need to create and submit the form in one session.

The fields marked with an asterisk * are mandatory and must be completed in order to submit the form.

After you have submitted your form, a copy of the submission will be emailed to the address entered below.

Your details

Title *

First name *

Last name *

Email *

Contact telephone

Organisation name

Address

Suburb

Postcode

Country *

Organisation description * Please provide a brief description of your organisation

Industry of interest Please provide a brief description of your industry of interest

Australian Business Number (ABN)

Privacy & confidentiality

Acknowledgement * I have read the department's Privacy Statement and agree to the department using my submission in the ways it's described.

I agree to the above statement.

Consent to be contacted about other activities * From time to time the Department of Industry may contact email subscribers about its programs and activities (for example, we may invite subscribers to participate in surveys). Check the box below if you agree to the department using your personal information to communicate with you about its other activities.

I agree to be contacted
I don't agree to be contacted

Connect program registration form

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