Trade Registration Form (Northern Territory)

By submitting this form, you’re confirming your intent to become a registered trade supplier with AGB Nominees Pty Ltd ATF AGB Trust TA Your Home SDA.

This registration helps us ensure that contractors working with us adhere to appropriate practices concerning licensing, insurance, and safe work. It also reflects a mutual commitment to professional, compliant, and reliable service outcomes.

You can view a copy of the Agreement here:

Click to View

Supplier Entity

Supplier's Full Legal Name

Trading Name

Supplier's Trading Name

Address

Supplier's Business Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

Supplier's Phone Number

(###)

###

####

Supplier's Email Address that will receive work orders

ABN

Contact Name

Name of authorised signatory

First Name

Last Name

Title

Job title of authorised signatory

Email address of authorised signatory

Availability

Please list your general working hours

Afterhours Availability

Yes, available for afterhours call-outs

No, not available afterhours

Or enter your rates below

If you don’t have a formal price list, please provide your standard labour rate, call-out fee, and any other relevant charges, including emergency call out rates.

Type of Service/Trade

Please specify your area of work

Please indicate whether you/your employees/contractors hold any of the following checks.

These checks may be required by Your Home SDA. Note: If you or your employees do not yet hold a valid NDIS Worker Screening Check, in home support staff must be present during attendance at a NDIS property if it is tenanted. You are required to confirm this when you arrive on site.

NDIS Worker Check

Working with Children Check

Vulnerable person-related employment check

Aged care sector employment check

Police Check (no more than 6 months old)

🔒 Privacy Notice
By submitting this form, you agree to AGB Nominees Pty Ltd ATF AGB Trust collecting and storing your information for the purpose of supplier registration, compliance and coordination of services.
Your details will be handled in accordance with our Privacy Policy — please refer to it for more information on how we manage your data.