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Arise Foundation - Questionnaire
The information you provide will help us to prepare for a conversation with the candidate. If you have questions about making a referral, please email us at admin@arisefoundation.org.au
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* Indicates required question
Are you referring from an organisation?
*
Yes
No
If yes, what organisation are you from? Provide contact details.
*
Your answer
Does the client consent to this referral being made?
Referrals will only be accepted with client consent.
*
Yes
No
N/A (click here if you are a self-referral)
Full name (candidate)
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Are you/candidate an Aboriginal or Torres Strait Islander?
*
Aboriginal
Torres Strait Islander
Both
Neither
Prefer not to say
Are you/candidate from a Culturally and Linguistically Diverse (CALD) background?
*
Yes
No
Prefer not to say
If so, what is the candidate ethnic background?
*
Your answer
Can you/candidate speak English fluently?
*
Yes
No
Do you/candidate need an interpreter?
*
Yes
No
Home Address
*
Your answer
Mobile Number
*
Your answer
What is your/candidate place of birth?
*
Your answer
If you/candidate were born outside of Australia, when did you arrive to Australia?
Your answer
What is your/candidate residency status?
*
Australian Citizen
Australian Permanent Resident
Australian Temporary Resident
Other
If you/candidate are a temporary resident, what is your current visa status?
Your answer
Contact details (email)
*
Your answer
Is it safe to email the client?
*
Yes
No
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