Register for a program

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Privacy statement*

I agree and understand that by submitting this registration form I am agreeing to the privacy statement and provide consent for Prosper (Project Australia) to collect and securely store my information. I also understand that photographs may be taken at this program for promotional purposes. I consent to this and know that I can withdraw my consent at any time by emailing mail@prosperprojectaustralia.org.

Select your program*

First name*

Last name*

Gender*

Date of birth*

Phone*

Email*

Suburb you live in*

Country of birth*

Language spoken at home*

Are you of Aboriginal or Torres Strait Islander descent?*

Do you have one or more of the following impairments, conditions or disabilities?

How many children under the age of 18 do you have?

Cultural ancestry*

Visa type

When did you arrive in Australia (month, year)

Do you care for someone with a disability?*

Are you eligible for the NDIS?*

Are you homeless?*

Household status*

Highest level of education*

Employment status*

Main source of income*

Frequency of income*

Approximate weekly income*

Name

This field is for validation purposes and should be left unchanged.