Application Form: Self-Employment Assistance

To be eligible for the Self-Employment Assistance, you must meet the following criteria:

I must be 15 years of age or older (I must be 18 years of age to access Small Business Coaching)
I am not prohibited by law from working in Australia
I am not an overseas visitor on a working holiday visa or an overseas student studying in Australia
My business is not a subsidiary, part of a multi-level marketing arrangement or intending to supply labour, products or service to a single business (i.e.: ride share or delivery drivers)
I am not undischarged bankrupt
I reside in either Sydney South West, Sydney Greater West, Sydney East Metro or Sydney North & West. (see map)
- In order for us to provide this service to you, the Department of Employment and Workplace Relations requires you to preside in one of the regions included above (Sydney East Metro, Sydney South West, Sydney Greater West, Sydney North and West).
- If you are unsure if your suburb is within one of these regions, click here to search the map in more detail.

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First Name	Last Name
Date of birth (dd/mm/yyyy)	Job Seeker ID (JSID)
Mobile	Postcode
Email	Suburb

Which best describes you?

What is your ABN Number?

When did you launch your business?

What is your business structure?

What support are you looking for?

Does your business contain less than 4 employees not including yourself?

Your business is not currently trading or is at risk of ceasing trading within the next 12 months

Will you be able to provide evidence to support your previous answer? These could include but not limited to:

Bank Statement

Profit and Loss statement

Balance Sheet

Income Statement

New Business Description

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In a few words, can you tell us about your business idea, and what products or services will your business offer.

Please also talk about how your customers will be able to purchase your product or service, (eg online, store front)

Who will be your customers?

Please also talk about any specific demographics, consumer behaviours or interests

Do you have any experience or qualifications relating to this product or service?

Please talk about any licences/qualifications you may have, or any that are required for your new business.

Have you researched your competitors and if so, what did you find?

Please also talk about how your product/service may be different to your competitors.

How will you fund your business?

Please let us know if you will need to purchase any equipment, if there will be any set up costs

Please tell us if you have any specific needs you would require our help with?

In a few words, can you tell us about your business, and what products or services you offer.

Please also talk about how your customers purchase your product or service, (eg online, store front)

Who are your customers?

Please also talk about any specific demographics, consumer behaviours or interests

What type of help are you looking for? (you can choose more than one option)

Please tell us what marketing help you need?

Please tell us what operational help you need?

Please tell us what financial help you need?

Please tell us what help you’re looking for?

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Participant Eligibility

Have you participated in Self-Employment Assistance, including Small Business Coaching before?

When did you last finish participating? (mm/yyyy)

Are you available to participate in small business training?

If accepted for small business training, please specify any special training requirements (Note: You don’t have to answer this question. We ask this to determine the level of service you may need from your Provider)

Are you an undischarged bankrupt? (Note: bankruptcy is usually discharged after three years. You can contact the Australian Financial Security Authority for more information)

Are you:

an overseas visitor on a working holiday

an overseas student studying in Australia?

legally able to work in Australia?

Business Eligibility

Do you have any business partners?

Provide full names of any proposed business partners also applying for Self-Employment Assistance

Provide full names of any proposed business partners not applying for Self-Employment Assistance. (Note: Please ensure you have notified proposed business partners that you will be providing their information to your Provider.)

Have you ever operated this business on a commercial basis?

Will your business be established, located and operated solely within Australia?

Will your business comply with all relevant laws and regulations, including Commonwealth, state, territory or local authority requirements?

Will you have a controlling interest in your business while participating in Self-Employment Assistance?

Will you work in your business on a full‑time basis? number of hours required to satisfy your Mutual (Note: full-time means 35 hours per week or the required to satisfy your Mutual

Obligation Requirements)?

Would you work part-time in your business due to any of the following?
- Part‑time/casual
- Employment
- Part-time
- Studies
- Caring
- Responsibilities
- Capacity to work due to medical condition/s

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Tell us a bit more about your personal details

Gender

Country of birth

Is English your first language?

What is your first language?

Do you require access to an interpreter?

Are you known by any other names?

(For example, a maiden name, previous married name Indigenous or community name.

Your contact details

Postal Address

Number and street/PO Box

Suburb or town

Postcode

State or Territory

Is your residential same as the postal Address?

YesNo

Residential Address

Number and street/PO Box

Suburb or town

Postcode

State or Territory

Best contact method

Home telephone number

Work telephone number

Mobile telephone number

Email address

Income support

Do you receive a payment from Services Australia?

Please provide the name of the payment. (Your provider will confirm the type of payment with Services Australia)

Personal circumstances

Are you an Australian citizen or permanent resident?

Are you a visa holder?

Please provide details about your visa and work rights

Are you an overseas visitor to Australia, or here on a working holiday?

Are you of Aboriginal or Torres Strait Islander origin?

Are you currently working 15 hours or more per week?

Subsection: working 15 hours or more per week

Are you in full-time Education or training?

Questions for retrenched workers and their partners

Have you or your partner been retrenched from your job in the past 6 months or will you be retrenched within the next 3 months?

You are eligible for immediate access to Workforce Australia Services

Please write the name of the organisation you or your partner’s position was retrenched from.

Please provide written proof of retrenchment, such as a letter from your Employer or an Employment Separation Certificate which includes the date or expected date of retrenchment.

For partners of retrenched workers:

Please provide written proof of your partner’s retrenchment, such as a letter from your partner’s Employer or an Employment Separation Certificate which includes the date of retrenchment.

If applicable, you will also need to provide evidence of living with your partner at the time of the retrenchment.

Transition to Work eligibility questions:

Do you have a year 12 Certificate or Certificate III or higher qualifications?

What is the certificate/qualification?

Did you get the certificate/qualification more than 6 months ago?

Have you been working an average of 8 hours or more per week for the last 4 weeks (32 hours)?

Have you worked in paid employment in the last 6 months?

Are you currently enrolled in secondary education?

Have you been enrolled in secondary education in the last 6 months?

Have you attended secondary education in the last 4 weeks?

Do you have an exemption from legal requirements to attend school?

Tick to confirm the young person is eligible for direct registration (Group 2) in Transition to Work (as per Transition to Work guidelines).

Yes

I understand what Transition to Work Services I can receive, including what help I can access to improve my work readiness and examples of activities that I may take part in.

Yes

I agree to participate in Transition to Work Services for up to 18 months unless I advise my Transition to Work Provider that I no longer wish to participate.

Yes

Proof of Identity

Do you have Drivers license number or Current Australian Passport or any other type of identification?

Group A: You must provide one of the following:

Drivers license number

Current Australian passport number

Other form of photo identification from a government department or agency

Please specify type of identification.

Identification number

Group B: You must provide two of the following:

Financial institution (bank) documents

ATM/credit cards showing name and signature

Bank statement showing your name and address

Other documents—any of the following documents:

Birth certificate or birth certificate extract

Certificate of Australian citizenship

Motor vehicle registration papers with current address

Australian marriage certificate

Documents showing registration of a change of name

Divorce papers

Trade certificate

Insurance renewal documents showing current address

Medicare card

Other

If other, please specify the type of the document

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Thank you for your inquiry into our Self-Employment Assistance.

It’s great you want to start a business! MTC will help guide you on which of the below options is best for you. One our experienced Business Coaches will be in contact with your shortly to help guide you on your best option.

Certificate III in Entrepreneurship and New Business (BSB30220)

This course will give you the skills to develop a Business Plan and run a business.

Micro Business Skill Set (BSBSS00102)

This course will give you specific skills in researching business opportunities and developing a Business Plan.

New Business Ventures Skill Set (BSBSS00103)

This course will give you skills to develop a business idea, create a proposal and organise finances.

Exploring Self-Employment Workshop

This workshop will give you the tools and resources to develop your idea into a business.

Thank you.

Thank you for your information. Our Customer Care team will be in contact with you within 1-2 business days so we can further understand your needs and how we can best assist you

Individuals

For Employers

About Us

Refer to MTC

Self-Employment Assistance – Application Form

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Thank you.