Contact Information
*
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First Name
Last Name
Contact Number
Please include area code
Email Address
Current Home Address
Suburb
State
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Australian Capital Territory
New South Wales
Northern Territory
Queensland
South Australia
Tasmania
Victoria
Western Australia
Other
Postcode
Current Postal Address
(if different from home address)
Suburb
State
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Australian Capital Territory
New South Wales
Northern Territory
Queensland
South Australia
Tasmania
Victoria
Western Australia
Other
Postcode
Date of Birth
dd/mm/yyyy
What is your gender / how do you identify?
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Male
Female
Non-binary
Are you a permanent resident?
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Yes
No
Emergency Contact Details
Name
Email Address
Contact Number
Please include area code if landline
Please tell us about you, your vision and your career history
Why do you want to apply for the Career Visions program?
Describe your current use of adaptive technology
What industry would you be interested in undertaking your 13 week work placement towards your DREAM job.
For example: Community Services, Finance, Law, Health, Arts, Information Technology, Education and MORE
What are your strengths and what are your identified barriers to gaining employment