Staff Data Entry Your total unsecured debt?*Please Select...Less than $10,000$10,000 - $30,000$30,000 - $50,000$50,000 - $80,000$80,000 - $100,000$100,000 +You have indicated you have less than $10,00 of unsecured debts. If you are struggling to get on top of this debt, there are other options you can consider before you try our services. These options are outlined below. If your debt situation worsens over the next few months, please feel free to get back in touch with us to discuss your debts in more detail. Free Financial Counselling Financial Counselling Australia offers a free service which puts people struggling with their finances in touch with a free financial counsellor. If you're having problems with debt, you can call the National Debt Helpline on 1800 007 007. www.ndh.org.au NILS The No Interest Loan Scheme provides individuals and families on low incomes with access to safe, fair and affordable credit. Loans are available for up to $1,500 for essential goods and services such as fridges, washing machines and medical procedures. Repayments are set up at an affordable amount over 12 to 18 months. For more information visit nils.com.auDebt DetailsYour employment status?*Please Select...Full TimePart TimeCasualPension/BenefitsUnemployedYour approx weekly income?*Please Select...Less than $300$300 - $700$700 - $1200$1200+Have you been bankrupt in the last 10 years?*Please Select...No BankruptcyI've been bankruptI've been in a Part 9 Debt AgreementAre you behind on repayments?*Please Select...Yes, more than 3 monthsYes, less than 3 monthsNo, but I am struggling to keep upNo, I am managingAre you a home owner?*Please Select...I have one mortgageI have more than one mortgageI own my home outrightI am renting/boarding/otherWhat's your credit rating?*Please Select...ExcellentGoodPoorUnknownContact DetailsFirst Name:*Last Name:*Email:* Phone:*State:*Please Select...A.C.T.New South WalesNorthern TerritoryQueenslandTasmaniaSouth AustraliaVictoriaWestern Australia This iframe contains the logic required to handle Ajax powered Gravity Forms.