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Request a quote with NDIS funding for one of our programs

Please fill out this form if the Participant will have access to NDIS funding.

Please note that places are limited for our programs and filling out the request for a quote form is not a guarantee of a program place.

Please email us at info@boystothebush.org.au or give us a call at 02 6025 2510 to discuss your requirements with our staff before completing this form.

Have you spoken to a Boys to the Bush Location Manager

Boys to the Bush Location *

Participant's Name *

First

Last

Participant's Date of Birth *

Participant's Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

MENtoring Programs

If you are interested in MENtoring, please select the frequency and also the term you want to be quoted for. Please click Not Applicable if you are not enquiring about these programs.

Programs *

MENtoring
Not Applicable

Program Terms *

Term 1
Term 2
Term 3
Term 4
Not Applicable

Camps

If you are interested in Camps, please select the type of camp and also the which school holiday you want to be quoted for. Please click Not Applicable if you are not enquiring about these Camps.

Camp Type *

Public Camp
Tailored Camp
Cultural Camp
Not Applicable

Camp Timings *

School Holidays - Summer
School Holidays - Autumn
School Holidays - Winter
School Holidays - Spring
Not Applicable

Care Arrangements

If you are interested in Care Arrangements, please select the type of care you want to be quoted for. Please click Not Applicable if you are not enquiring about this Care service.

Care *

Alternative Care Arrangements/Respite/Emergency Care
Not Applicable

Invoice Information

This information will be used to personalise our quote back to you.

Referring Agency *

Support Coordinator's Name *

First

Last

Support Coordinator's Phone *

Support Coordinator's Email *

Plan Manager's Name *

First

Last

Plan Manager's Phone *

Plan Manager's Email *

NDIS Reference Number

NDIS Budget *

Line Item Number to be Used *

Other Comments

© 2022 Boys to the Bush. Big Agency
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Staff Forms
Boys to the Bush recognises the Aboriginal and Torres Strait Islander Peoples as the true custodians of the land in which we live, work and play.

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