NTEU VIC App

1. Union rep name
2. Union rep email
3. Member's name
4. Phone no. or member or next of kin
5. Nature of enquiry
6. Employer/Worksite
7. Will kit shipping address
8. Suburb
9. Post code
10. State
11. Number of will kits
12. Please specify nature of enquiry
13. Other Information
14. Nearest office
15. Date and time of incident
16. Best time to call
19. Have you advised the member of this referral to Maurice Blackburn and do you reasonably believe the member will not object to being contacted?

Union rep name

Union rep email

Member's name

Phone no. or member or next of kin

Nature of enquiry

Select an enquiry type Injured at work Injured in a road accident Exposed to asbestos Need to make a super claim Injured by medical treatment Injured in a public place Wills - request a free will kit Will dispute Free legal advice Other

Employer/Worksite

Will kit shipping address

Suburb

Post code

State

Select... ACT NSW NT QLD VIC SA TAS WA

Number of will kits

Please specify nature of enquiry

Other Information

Nearest office

Nearest office Brisbane Browns Plains Bundaberg Caboolture Cairns Darwin Gold Coast Ipswich Mackay Rockhampton Strathpine Sunshine Coast Toowoomba Townsville

Date and time of incident

Best time to call

Best time to call Morning Afternoon Evening

Have you advised the member of this referral to Maurice Blackburn and do you reasonably believe the member will not object to being contacted?

Yes

No

Submit