NEIS Enquiry Form Are you aged 18 or over*YesNoHave you received NEIS assistance for a similar business activity in the past 12 months?*YesNoName* First Last Phone*Email* State*New South WalesQueenslandVictoriaWestern AustraliaSouth AustraliaNorthern TerritoryTasmaniaAustralian Capital TerritoryWhat suburb do you live in?*What suburb are you planning to open your business in?*If you aren't sure where your business will be located, please list the region i.e. South-west SydneyTell us a little bit about your business ideaHow did you hear about us?*GoogleBingFacebookInstagramTwitterLinkedInFrom a friendReferral Partner eg CentrelinkOtherLet us know here if you were referred, found us through google or on social media.