Building Accessible Workspaces - Employer EOI

This form is for the purpose of collecting contact information for employers interested in being a part of Wayfinder's Building Accessible Workspaces Program.

All information collected in this form will remain confidential and will not be shared with any third parties other than the name of the business with the Grant Body - Department of Social Services.

This program is funded by the Australian Government Department of Social Services.

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* 1. Business Name (correct legal entity)

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* 2. Business Contact Name

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* 3. Business Contact Number

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* 4. Business Contact Email

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* 5. I am interested in having a BAW representative visit my business and support me to make my workplace more accessible.

Yes

No

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* 6. I am interested in receiving resources that help me to make my workplace more accessible

Yes

No

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* 7. I am interested in being directed toward third parties that help my business become more accessible

Yes

No

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* 8. I understand that by taking part in this project I will be required to undertake an intake survey as a part of the reporting conditions set by the grant body (Department of Social Services)

Yes

No

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* 9. I would like some more information on the project before being considered as a participating business

Yes

No

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* 10. I consent to being contacted by Wayfinder's BAW Program Coordinator (Felicity Dillon) and wish to be considered a participating business.

Yes

No