Part 1 Applicant Details

  • Q1 Please choose only ONE option from the list.
    An organisation that is not a legal entity is NOT eligible to apply.
    FaHCSIA will only enter into Funding Agreements with legal entities.
  • Q2 This is the name of your organisation that appears on all official documents and legal papers. It may be different to your trading name.
  • Q3 This is the name your business/organisation trades or provides services under for commercial purposes. It may be different from your legal name.
  • Q4 This is the registered business address of your organisation.
  • Q5 Please provide address details for the delivery of mail. This may be different from your actual street address.
  • Q6a Please provide contact details of one officer who has been authorised by your organisation to be contacted by FaHCSIA to answer any questions in relation to the application.
  • Q6b Please provide contact details for an additional officer who has been authorised by your organisation to be contacted by FaHCSIA to answer any questions in relation to the application should the preferred contact not be available.
  • Q7 Please indicate if you are currently a panel member of the Helping Children with Autism (HCWA) Package.
  • Q8 
    • (a) the legal entity - Only choose this option if you have entered into a deed of agreement with FaHCSIA to provide services under the HCWA package.
    • (b) sub-contractor/consortium member - Only choose this option if you have entered into an agreement with a provider/organisation that is a member of the HCWA Early Intervention Provider Panel.
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DSS2799 | Permalink: www.dss.gov.au/node/2799