Referrals

Referrals

Thank you for referring your client to the Working Women’s Centre SA. Please complete the form below and a member of our team will be in touch as soon as possible.

Referrer details
Name of agency referring client*
Your name*
First Last
Your position
Your phone number*
Client details
Name of client*
First Last
Phone number*
Email*
Employer*
Employment status*
Date of dismissal (if relevant)
DD slash MM slash YYYY

Please note for unfair dismissals the employee has 21 days from the date of dismissal to make an unfair dismissal application.
Are they a union member?*
- Yes
- No
Details of the assistance required / problem type*
This referral has been discussed with the client and they have consented to the referral*
- Yes
Email
This field is for validation purposes and should be left unchanged.

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Referrer details

Client details

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