Intake

Your First Name

Your Last Name

Your Date of Birth

Do you identify as Aboriginal and/or Torres Strait Islander?

Your Phone Number

If outside of Australia, please include a country code.

Is it safe for us to call you and leave a voice message?

Your Email Address

Is it safe for us to email you?

You can find information about email safety at: techsafety.org.au

Your Address Line 1

Your Address Line 2

Your Suburb

State

Your Postcode

Country

Other Parent's First Name

The Other Parent's Last Name

The Other Parent's Date of Birth

Your Child's First Name

Your Child's Last Name

Your Child's Date of Birth

Your Enquiry

Please write a short description of your enquiry, for example, "my child was taken outside of Australia without my consent". If this enquiry relates to more than one child, please also include the full names and dates of birth of the other children here.

Which country (other than Australia) does your enquiry relate to?

Intake Form

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