Midland Frederic SIL House

First Name*

Last Name*

Your Email*

Phone Number*

I am a...*
Person with disabilityFamily memberSupport CoordinatorLegal GuardianOther

Who are you referring?*
Select an optionYourselfFamily MemberYour clientOther

Do you/ the individual you are representing, have an NDIS plan?*
YesNoUnsure

What is your / their funding source?*
NDISDSOAICWADepartment of Child ProtectionDepartment of CommunitiesUnsureOther funding source

What services are you looking for?*
You can tick both options if you wish.
SIL (Supported Independent Living)SIL + SDA (Supported Independent Living + Specialist Disability Accommodation)

Where is your preferred disability accommodation area in Perth?*
You may select multiple locations.
NorthEastSouthAnywhere in Perth metro area

Are you interested in having a tour of a new SDA home?*
Yes, I want to be invited to the next Affinity Care WA Home OpenNo, I already know the benefits of SDA housing

How did you hear about us?*
Social mediaGoogleSupport Coordinator / Plan ManagerWord of MouthEmail from Affinity Care WAPost / mailEvent / ExpoRadioOther

Additional comments
This is for our NDIS Supported Independent Living (SIL) accommodation vacancies only. For career related submissions, please complete our contact form.