Registration questions

Question 1
Indigenous status (you must answer Yes to one of the questions below to become a licence holder)

1. For businesses and organisations Are you a representative of an Indigenous business or organisation? *

if Yes go to 3. If No go to ineligible notice.

2. For Individuals Are you of Aboriginal or Torres Strait Islander descent? *

if Yes, go to 21. If No go to ineligible notice.

If YES it is a business/organisation:

Question 2: Indigenous organisation applications

3. Are over 50% of your organisation�s Board of Aboriginal or Torres Strait Islander descent?

4. Is your organisation interested in producing MARVIN messages for commercial clients in a sub-contracting arrangement with NTICED?

5. What is the name of your organisation?

6. Chief Executive Officer (CEO) name or business owner:

7. Postal address:

8. Physical address:

9. Contact number:

10. (ABN or equivalent)

11. What is the main business of your organisation?

12. How many people work full time for your organisation?

13. How many people work part time for your organisation?

14. Does your organisation receive Federal Government funding?

If Yes, go to 15. If No, go to 16

15. What does the Federal Government fund your organisation to do?

16. Does your organisation receive State or Territory funding?

If Yes, go to 17. If No, go to 18.

17. What does the State or Territory Government fund your organisation to do?

18. Does your organisation have internet access?

19. How many computers does your organisation have?

20. How many of your organisation�s computers are linked to the internet?

Question 3: Indigenous Individual applications

21. Are you accepted as an Aboriginal or Torres Strait Islander in the community that you live in?

22. Name:

23. Address:

24. Contact number:

25. Do you have a computer at home?

26. Do you have the internet at home?

27. Are you in full or part time employment?

28. Are you currently doing any training?

If Yes, give details of the expected training qualification

29. Would you like to learn how to become a MARVIN instructor? Instructors may get to travel overseas. People who want to become a MARVIN instructor need to do extra training first.

Questions 4: Location

30. Where do you live? Tick one of the following:

Question 5: Preferred Training Location

31. Tick one of the following:

Other:

Question 6:

Privacy and use of Information Provided Your personal details are being collected by the Northern Territory Institute for Community Engagement and Development (NTICED) for the purposes of supplying you with a software licence to use the MARVIN software. The information collected from this registration site will be provided to the Department of Education, Employment and Workplace Relations and may be used by the Australian Government for research purposes relating to the use of MARVIN software by Indigenous individuals and organisations. The information provided by you will not be released to any other party and will not be used for a purpose that is not consistent with the reason for which it was collected originally by NTICED. The information will not be used to make decisions that may be detrimental to you or contrary to your interests. If you have any questions about the use of the information supplied you can contact the Director, Indigenous Self-Employment and Economic Engagement Team, Indigenous Employment and Business Group, Department of Education, Employment and Workplace Relations. Toll free number: 1300 363 079. Do you agree to your personal details being collected for the purposes outlined above?

Question 7:

Restrictions on use of Licence Messages created using the MARVIN software must be consistent with government policy and priorities and not involve promotion of the sex industry, production and distribution of pornography or other products or activities not culturally or socially appropriate in the relevant community. All messages created as a result of involvement in this project which are created using the MARVIN software provided through this project, must not promote the sex industry or contain references of a sexual nature, explicit language or pornographic imagery. MARVIN licence holders are not permitted to undertake message creation on behalf of a third party which promotes alcohol use. Community messages can be created to address issues of substance or sexual abuse in a community. Do you agree to use MARVIN in accordance with these restrictions?

AgreeDo Not Agree  

Question 8:

Further Information on Australian Government Programs Would you like to receive further information on the following Australian Government programs?

Business development

Training/education

Employment