SPARK

  • Application Form SPARK Telethon Program

  • Welcome to the Application for the SPARK Telethon Program, proudly developed and facilitated by ADHD WA with the generous support of the Telethon 7.

    This is an initial step in the application process, and it typically takes approximately 20 minutes to complete.

    SPARK Telethon Key Subsidy Criteria

    1. Waiting time for assessment, treatment or support exceeds 5 months.
    2. Child is homeschooled or at risk of disengagement from formal education.
    3. Other family members in the household with ADHD (diagnosed or undiagnosed)
    4. Annual family income below 55K (individual) or 130K (combined family income)

    We deeply appreciate your interest in the SPARK Telethon Program and look forward to the opportunity to support you and your family on this journey.

    Thank you!

    Contact Us:
    📧 SPARK@adhdwa.org
    ☎️ (08) 6255 8880

    When you submit this form, it will not automatically collect your details like name and email address unless you provide it yourself.

  • Link to the Privacy Statement

  • Personal Details

    Child's/adolescent's details
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  • Next of Kin Details

  • Consent

    You have the option to withdraw your consent at any time by informing ADHD WA via email SPARK@adhdwa.org.

  • Demographics

  • Education

  • Legal Matters

  • Health and Wellbeing

  • Risk Factors

    Is the child/adolescent at risk?

  • Accessibility and Engagement

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