Sign up as an affiliated business

Join the Companion Card program

To join the Companion Card program please fill in the online form below.

For more information please contact NSW Companion Card on 1800 893 044 or affiliates.companioncard@dcj.nsw.gov.au.

You should also view the affiliate terms and conditions.

What affiliated businesses get

When you send in your Industry Affiliation Form, you’ll be sent a variety of promotional materials including Companion Card brochures and ‘Companion Card accepted here' stickers.

Please display this promotional material prominently so it can be easily seen by Companion Card holders. We recommend displaying it:

in your customer service areas
at ticketing outlets
on promotional materials.

You can also promote your membership by including a Companion Card image and link to the Companion Card website on your business/event website.

Required field

1. Business details

Business name

Trading name

Business address

Suburb

State

Postcode

ABN / ACN

Phone

Email address

2. Contact person

First name

Last name

Position in organisation

Phone

Email address

3. Service profile

Please provide a brief description of your organisation's activities

The description will appear in our affiliated business listing. (Limit 300 characters)

300 character(s) remaining

4. How did you hear about the Companion Card?

Select option/s

Community organisation

Cardholder/Carer

Other

5. Affiliated business statement

On behalf of the organisation:

I understand and accept the affiliated business terms and conditions and agree to accept the Companion Card at all our outlets.
I consent to the information provided above to be used on the Companion Card website or in other promotional communication as a Companion Card affiliated business.

I agree to the Companion Card terms and conditions.

Name of authorised representative

Position in organisation

Date

6. Privacy

The information collected will be recorded and stored in the Companion Card database and used for administering the Companion Card program in accordance with the privacy principles in the Privacy and Personal Information Protection Act 1998 (NSW).

Privacy Collection Notice

This form collects personal information. Please read the privacy collection notice for more information about how we handle your information.

I confirm that the information I have provided is directly relevant to the completion of this form, and if I provide the personal information of another person, I have obtained that person's authorisation to do so and to submit this form. Please read the privacy collection notice for more information about how we handle your information.