Online Enquiry Form

This form enables you to ask the JobAccess Adviser questions about employment for people with disability, Employment Assistance Fund and adjustments or topics you have seen on this web site.

The JobAccess Adviser will provide a response according to your preferred contact method.

Important security information

Please be aware that this online form is not a secure form.
To protect your privacy, personal information and/or confidential information should not be communicated using this form.

What is personal information?
What is confidential information?

Please complete all fields or select 'Clear' to start again.

Preferred name


What is the enquiry about?

Use the space below to tell us your enquiry. (Please remember not to send personal or sensitive information)

Postcode
How did you find out about JobAccess

Important security information

What is personal information?
Personal information is information that you provide to us which personally identifies you or your clients, such as full names, client record information, financial information or other data that can be reasonably linked to such information.

What is confidential or sensitive information?
Confidential or sensitive information includes confidential medical information, information about racial or ethnic origins, political or religious beliefs or sexuality and is tied to personal information.

Telephone area code		Telephone number
Re-enter telephone area code		Re-enter telephone number

Fax area code		Fax number
Re-enter fax area code		Re-enter fax number

Address line one
Address line two
Address line three
Suburb
State

Email address
Re-enter email address