1. Applicant details
  2. Eligibility
  3. Offender details
  4. Supporting documents
  5. Review & submit

Applicant details

All fields are required unless marked (optional).

Pronouns
Have you been known by any other names?
Gender

Home address

Contact details

Please provide your contact details

Postal address

Is your postal address different?
Are you linked with a Victims Assistance Program (VAP)?
Do you need an interpreter?

Preferred contacting method

The Victims Register will generally communicate with you in writing via email. Please provide us with:
If email is not your preferred contact method, please provide your preferred contact method.
Mobile phone
Home phone

There may be a time when the Victims Register needs to contact you quickly.

Please list your contact details, and indicate if the Victims Register can leave a message for you by ticking Yes or No below.

Email address
Mobile phone
Home phone