Namatjira Haven Self Apply Form

Thank you for taking the time to apply for a place in our program. This online form is only to be used if you are applying for your self. If you are referring someone else please use the PDF form for Referrers. This form will only take a few minutes to complete. When submitted it will be automatically emailed to us.

Please remember to follow up your application within 2 working days by calling 02 6628 1098 and ask to speak to the Intake Officer.

The information you provide here is protected by privacy law - it is confidential to our service and will not be disclosed to anyone outside our service without your consent except where the law requires it to be disclosed. Anonymous data that does not identify you may be shared for reporting, research and evaluation purposes. For more information please see our privacy policy.