Seniors Security Subsidy Scheme Registration

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Seniors security subsidy scheme

All fields are required except where indicated
 
Note: street number and street name are needed for all addresses
Is the installation address the same as above?:
Do you have a valid Senior Card?:
Do you have a valid pensioners card:
Items installed Quantity Subsidy Value $ Total Company selected
Roller Shutters
300 $0
Home Intruder Alarm
200 $0
Security Screen Door
100 $0
Sensor Light
45 $0
Door deadlocks
40 $0
Security Window Screen
40 $0
Door Viewer
20 $0
Keyed Window Locks
20 $0
e.g. copies of receipts
Are you the owner?:
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Contact

Address

9 Coleville Crescent,
Spearwood 6163

Po Box 1215, Bibra Lake DC,
Western Australia, 6965

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