Legal Name (required)

Preferred Name

Pronouns She/HerHe/HimThey/ThemShe/TheyHe/They

Gender IdentityMaleFemaleIntersex or IndeterminateOtherTransgenderX (not Male or Female)

Income Negative incomeNil income$1–199 weekly ($1–$10,399 yearly)$200–$299 weekly ($10,400–$15,599 yearly)$300–$399 weekly ($15,600–$20,799 yearly)$400–$599 weekly ($20,800–$31,199 yearly)$600–$799 weekly ($31,200–$41,599 yearly)$800–$999 weekly ($41,600–$51,999 yearly)$1000–$1249 weekly ($52,000–$64,999 yearly)$1250–$1499 weekly ($65,000–$77,999 yearly)$1500–$1999 weekly ($78,000–$103,999 yearly)$2000 or more weekly ($104,000 or more yearly)

Postcode

Date of Birth

Phone Number

Is it safe to contact you on this number?

YesNo

Email Address

About You

Do you identify as Lesbian, Gay, Bisexual, Transgender, Intersex, Queer or any other gender or sexuality identity? BisexualGayIntersexLesbianQueerTransgenderParent of LGBTIQ+Cis/HetroN/AOther/Unspecified

Are you a sex worker YesNoPrefer not to say

Are you at risk of homelessness? YesNoAt risk

Do you identify as Aboriginal or Torres Strait Islander? NoYes-AboriginalYes-Torre Strait IslanderYes-bothUnknown

What is your visa status? CitizenPermanent ResidentBridging VisaFamily/Partner VisaHumanitarian/Protection VisaStudent VisaTemporary/Skilled Worker VisaNew Zealand CitizenSpecial Category VisaTemporary Graduate VisaUnknown/Other

The legal issue

Sex worker Legal ServiceTrans and Gender Diverse Legal ServiceCriminal ChargesFinesDebtEmploymentFamily lawDiscriminationOther

Description

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