EVENT – Aspiring Leaders Program NDIS

• Do you want to be part of the future of the NDIA and service delivery in WA?
• Do you want to know more about leadership?
• Do you have an intellectual disability, live in the Perth Hills Area and are 18 or older?

Then come and talk to us about the Aspiring Leaders Program.
Wednesday October 14th 2.30 – 3.30pm

This will be the final information session
At the NDIA office – the brown and blue building on the corner of Marion Street and Railway Parade in Midland.
Street parking is available.

Want to know more or let us know you are coming along?

Contact Jane at E-QUAL on 08 9389 9930 or Jane at E-Qual or you are welcome to bring someone with you on the day.

Please let us know if you have any access needs.

Application Form:
This project is funded by the National Disability Insurance Agency

About you
Name:

Are you 18 years or older? Yes No

Do you have an intellectual disability? Yes No

Are you registered with the NDIA? Yes Not yet

Home address:

Suburb:

Postcode:

Mobile:

Email:

Why do you want to do this Leadership program?

What would you like to do to make West Australian disability services better?

Please provide contact details for two people who think this would be a good program for you.

Person one
Name:
How do they know you?
Mobile:
Email:

Person two
Name:
How do they know you?
Mobile:
Email:

Please return this form to:
Jane Hannay
E-QUAL
PO box 200
Nedlands
WA 6009

Or Jane at E-Qual
If you have any questions call on 9389 9930