First Name *Last Name *Suburb *Please enter your suburb or post codeEmail Address *Communication methodHow do you like to communicate?Phone Number *Your goals *How will ‘Visual Arts Together’ services and programs support the goals in your current plan?Are you currently attending an art/day program with another organisation?If yes, please enter the name of the organisationService Delivery and LocationI require 1:1 ‘in-home’ serviceMy preference is to join a community based group activityWhat level of support do you need?Participation in Group and Centre Based Activities *Please select oneWith a CarerSupport WorkerArrive IndependentlyNone of the Above. I require in-home support services.Will you be attending with a carer, support worker or arrive independently?Using MediaAre there particular art materials that you love to use?ArtformsNoYesPaintingSculpturePotteryDrawingPrinting: e.g lino printing, monoprintingMaking Artist BooksOtherAre there new artforms that you’d like to try? Tick the boxes that apply to youManaging your NDIS funding *Please select oneSelf-managed – I manage my plan by myself (or with the support of an advocate, family member etc)I am NDIA-managed – the NDIA manages my plan for mePlan-managed – a Plan Manager helps me manage parts of my planHow is your plan managed?What is your NDIS participant number? *You will find your number on your access letterContact details of your Support Coordinator, Family Member or Advocate *When is your plan due for renewal? *Please enter the date.Is there anything else I need to know to better support you?Please add any other informationIs there anything you need to know from me? Please add any data for me. Send Message
