REGISTER YOUR INTEREST FOR NEIS
NEIS Registration Form
Mobile phone number
Have you registered for a NEIS information session in the last 3 months?
Are you on a Centrelink benefit?
What Centrelink benefit do you receive?
New Start DES
Disability Support pension
Parenting payment single
Parenting payment partnered
Who is your Job Active provider?
Example: NORTEC, Tursa,, ETC , BEST Employment
What is your Job Active providers location?
Work Advisor's Name
Work Advisor's Email address
Let us know the reasons why you are interested in NEIS and a short description of your business idea
How did you hear about us?
Word Of Mouth
NORTEC team member
Other Job Advisor
Are you currently working?
YES - Full Time
YES - Part Time/Casual
YES - Volunteering
NO - Not Working
Who completed this form
NORTEC call Centre staff
Select your location
Gold Coast - (Tweed Heads to Coomera)
North Coast - (Yamba to Kingscliff/Murwillumbah)
Mid North Coast - (Grafton to Forster)
New England/NSW North West
Please select your preferred North Coast information session
Please select your preferred Gold Coast NEIS information session
Coolangatta: Monday 22nd July, 10am-12pm@Kirra Hill Community & Cultural Centre, 1 Garrick St, Coolangatta
Nerang: Monday 5th August, 10am-12pm @ Nerang Library, Cnr Price & White St, Nerang
Please select your preferred Mid North Coast NEIS information session
Grafton: Tuesday July 30th, 10:00am - 11.00am @ NORTEC 144 Fitzroy St, GRAFTON NSW 2460
Coffs Harbour: Monday July 29th 10:00am - 11:30am @ NORTEC 34 Moonee St, COFFS HARBOUR NSW 2450
Taree: Friday August 2nd 10am - 11.30am @ NORTEC 102/1 Pulteney St, TAREE NSW 2430
Port Macquarie: Thursday July 31st 10am - 11:30 @ NORTEC 1/8 Short St, PORT MACQUARIE 2444
Please register for the New England NEIS information session
Phone conference: Tuesday 30th July @ 2pm, please double check you have entered your correct mobile number
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