= Required Fields Online Form - 'Vulnerable Persons Register' or 'Can You Help Register' Your full name: * Contact Number: * Email address: * Your Residential Address: Which Register are you signing up for? Vulnerable Person RegisterCan You Help Register If you selected the 'Can You Help' Register, outline here what your offer is: If you selected the 'Vulnerable Person' Register, in what way do you require assistance? Weekly Check InWeekly Phone CallAssistance to Get Essential ItemsOther If you selected 'Other', please outline here what other type of Assistance you require: Get Audio CodeType the code from the image
Shire of Gingin Offices Gingin 7 Brockman Street Gingin WA 6503 T: (08) 9575 5100 F: (08) 9575 2121 E: mail@gingin.wa.gov.au Lancelin 255 Vins Way Lancelin WA 6044 T: (08) 9575 5155 F: (08) 9575 2121 E: mail@gingin.wa.gov.au