All service providers must read the Hunter Homeless Connect Inc. Code of Conduct before completing the application form. Please click here to read, before proceeding with your application. Registrations are now open. SERVICE REGISTRATION DETAILS Organisation Name * Sub Agency Title Your unit's title within your organisation Service being offered Address * City * Postcode * Contact Name * Name and title of person completing this form Business Phone * Mobile Email Address * A valid email is required DETAILS OF STAFF ATTENDING ON THE DAY Primary staff member attending on the day Primary staff member's mobile Primary staff member's email Other staff member attending on the day HUB PREFERENCE There are 13 hubs and 4 coordinator areas, please tick the appropriate one to your service. Your service may be appropriate to more than one hub, if so, please select the appropriate hubs and we will do our best to accommodate you in each. Each hub has a volunteer Hub Leader who will be in contact with you once they receive the approved, numbered registration form from the HHCD Coordinator. The Hub Leader is responsible for ensuring that your involvement in the event is as seamless as possible, so it is important that you both work closely together. Click here to download a copy of the registration and insurance application guide (PDF, 501 KB). Hub Preference Catering Connections (Library/TAFE) Entertainment Families Health Screening & Information Housing & Accommodation Legal & Financial Opportunities (Employment & Training) Pets Social Work Sport & Recreation Wellbeing (Hair / Massage / Chiropractor) Youth For more information, see attached registration and insurance application guide. PUBLIC RISK INSURANCE DETAILS (NB Self insured government departments are not required to complete this section) Have you read the Code of Conduct? * Yes I have Insurance? Yes No If yes, please attach current Insurance Certificate of Currency below. Name of Insurer Policy Number Expiry Date Day Day12345678910111213141516171819202122232425262728293031 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Year Year201920202021202220232024 Type of Cover ABN/ACN Email Address Insurance Certificate of Currency Files must be less than 2 MB.Allowed file types: gif jpg jpeg png txt rtf pdf doc docx rar zip.