Disability Employment Services (DES) - Registration

Name*

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Phone*

Email*

Postcode*

Are you an Australian permanent resident/citizen living in Australia, OR a Temporary Protection Visa Holder, OR a Safe Haven Enterprise Visa Holder, OR New Zealand citizen living in Australia who holds a Special Category Visa?*

Yes
No

Do you currently have a Disability Employment Service (DES) Provider?*

Yes
No

Do you have a health condition/disability/injury?*

Yes
No

Are you able to work more than 8 hours a week?*

Yes
No

Are you a full-time student?*

Yes
No

What is your preferred method of contact?*

Phone
Email

Comments?*

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Disability Employment Services (DES) – Registration

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