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* 1. First Name

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* 2. Last Name

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* 3. Address

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* 4. Date of Birth

Date

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* 5. Gender

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* 6. Are you Aboriginal or Torres Strait Islander

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* 7. Are you currently at School? Please note school students are not eligible for this program.

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* 8. Are you currently employed?

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* 9. If you are employed, please indicate your employment type

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* 10. If you are employed, please indicate the number of hours of paid employment per week

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* 11. Please provide your job seeker ID if you have one and know it

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* 12. Are you registered with an employment service provider?

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* 13. If you are registered with an employment service provider, please indicate your provider

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* 14. What is the highest level of education you have completed?

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* 15. What was your main activity before registering for this project?

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* 16. Do you have a

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* 17. What are your reasons for wanting to be part of this program?

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* 18. How did you hear about the program?

Thank you for completing the Activate Business Registration Process. We will be in touch very soon to discuss the next steps!
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