Supporting small business recovery North Queensland 2019 - Page 1 of 2

If you are a small business owner whose business has been impacted by the floods, you don't have to re-build alone.

By filling out the form below, our Small Business Recovery Centre will prioritise enquiries and access support from local, state and federal agencies ready to lend a hand.

Information provided will also assist us to assess the impact of recent flooding on your business and determine further financial assistance.

Any information you provide is confidential.

Please note: fields marked with an asterisk (*) are required.


Contact details

1. Business Name*
2. First Name*
3. Last Name*
4. Job Title
5. Email*
6. Business Phone*

Physical business address

7. Address Line 1*
8. Address Line 2
9. Suburb*
10. Post Code*


11. Would you like someone from the Townsville Recovery Centre to contact you?*

12. What services are you interested in? (choose all that apply)
Rental tenancy/Landlord communications
Financial/government assistance
Business mentoring support
If other please provide details


13. ABN


I authorise DESBT to provide my details to third parties to provide me with tailored information and support.

The information in this survey will assist the State Government to provide better services to the community to promote recovery from the natural disaster.

Your details will be provided to third party agencies to provide you with tailored information and support. Your information will also be retained on the Department of Employment, Small Business and Training (DESBT) Customer Relationships Management (CRM) database. Your information will not be disclosed for any other purpose unless you consent or it is authorised or required by law. For more privacy information go to

You may opt-out of any contact we initiate with you at any stage. Go to to learn more about privacy and our CRM and the Business Queensland website.