Application for a NSW Working With Children Check registration

Personal details
Title *
First given name *

OR No first given name
Other given names *

OR No other given names
Family name *
Single name only
Gender *
Female Male Other
Contact details
Either a mobile phone number or an email address is required for notification purposes. At least one contact phone number is required.
(Australian only)
(Include area code)
(Include area code)
Current address
*
*
*
*

Mailing address *
*
*
*
*
Birth details
Date of birth *
*
*
*
Purpose of check
*
Paid employee
Self employed
Volunteer, authorised carer, adult household member, student on a professional placement, prospective adoptive parent
*
Identity documentation
If available, please provide your NSW Australian driver licence number (current or expired within the last 2 years)
Previous names and aliases
*
Yes No
Maiden name (If applicable)
Previous names
Aliases