Campaign to Reform NDIS

 Fulfilling the Promise to
Revolutionise Disability Services

Participation Form

I wish to participate in Reforming NDIS.

Please provide the following contact information


Category (you may tick more than one):

 NDIS participant
 Person with disabilitiies
 Support worker
 Support coordinator
 Service manager
 Community organisation staff 
 Government officer

My federal electorate is: 


  I would like to act as a Campaign Coordinator in my federal electorate.

  I would like to join the Campaign Steering Committee.

I have the following skills:

 Community networking
 Media skills
 Policy writing
 Lobbying experience
 Social media skills
 Graphic design skills

Tell us about yourself and your interests:


I would like to participate in a Local Area Network of Peers to develop mutual supports

I would like to participate in a Circle of Support for:                                              


Name of your local area / local government area:

Please tell us if you have had previous experience in support networks or circles:

         I would like a speaker to visit our group or organisation to talk about this Campaign



[Please note: We will send a confirmation of acceptance as soon as possible:
if after submitting this form you receive an error message, please disregard it.]