STA Booking Form

Privacy and Consent: By completing this form and submitting it to TDC, you are consenting to TDC using the information within this form for the purposes of quoting, coordinating and arranging your STA. TDC will only share your information where it is required by law or where we have to share your information to book and maintain your STA.

Who's taking a well deserved break?

Participant First Name *

Participant Last Name *

Participant Preferred Name and Pronouns *

NDIS Number *

Participant Contact Number *

Participant Address *

Participant Email AddressIf Self Managed, we will need an email for the Participant

Who's coming along?

Travellers may be your friends, family partner or your own independent support worker. You don't need to bring other people if you don't wish, if you aren't just leave this blank.

Please Note: Where an independent support worker is travelling with you, we will need to get intouch with them so they have our details if any changes or mishaps occur.

All travellers names need to be as per their licence, passport etc. This ensures no mishaps in checking in to accommodation or issues if emergencies occur. Where a name is mostly different than what is booked, a change fee may be payable.

Traveller 1 - First and Last Name

Relationship to Participant

Traveller 1 Age

Contact Number

Email Address

This person consents to TDC being provided this information for the purposes of this STA only *

Traveller 2 - First and Last Name

Relationship to Participant

Traveller 2 Age

Contact Number

Email Address

This person consents to TDC being provided this information for the purposes of this STA only *

Traveller 3 - First and Last Name

Relationship to Participant

Traveller 3 Age

Contact Number

Email Address

This person consents to TDC being provided this information for the purposes of this STA only *

Who would you like to be the main contact for your STA? This maybe for changes, cancellations or other situations. * This is the person we will contact for changes, cancellations or other situations that may arise. This person should also know they are the main contact person for this STA.

Do you need TDC Team Members to support you?

We're a helpful bunch! Please choose below if you would like a TDC support worker to assist you during your STA *

YesNo

Who is your support worker on this STA? *

Traveller 1Traveller 2Traveller 3

We will contact them to arrange times, activities and provide them an itinerary so they are in the know.

Your STA automatically includes up to 12 hours of support in a 24 hour period. Do you require more than 12 hours? *

YesNo

How many hours of support do you need in a 24 hour period? *

Do you need more than one support worker with you at any time? *

Yes, I need 2 support workers at all times to support me.No, 1 support worker is all I need at any time.

Our team members need to take breaks. Do you require them to stay with you? *

YesNoI don't mind

Interpreter Requirements

Do you need an interpreter? *

Yes No

What Interpreter do you need and who can we contact to fund your interpreter? *

When would you prefer to start and end your STA?

STA's are usually between 2 - 28 nights. If you are needing longer, Medium Term Accommodation (MTA) may be more suitable for you. Speak to your Support Coordinator or Plan Manager about this option before submitting this form.

Please note: Check in to your accommodation is usually 2pm and check out in 10am. So for example, if you live an hour away from your first preference location, you may want to leave your home at 1pm and record 11am as your time to finish.

Start date and time *

Finish date and time *

If your preferred day to start is not available, are you flexible a day either side? *

Will you need TDC support workers to transport you from your home to your accommodation and return? *

YesNo

How will you be getting to your STA?

Where would you like to go?

Destination Preference 1 *

Destination Preference 2 *

Destination Preference 3

Accommodation Details

Where would you like your accommodation near? *

A BeachA Lake or RiverIn nature and not near busy areasA quieter side of town but still close to activitiesI want to be amongst the hustle and bustleI don't mind, as long as it saves money on my NDIS budgetOther

Other Details

Other Accommodation Facilities Required

Your hotel will need to take a refundable room deposit, usually this is between $200 - $300. Who will be paying? *

I can pay with my own cardI would like TDC to PayAnother traveller can pay

TDC Support Workers cannot pay for room deposits. Where TDC has paid and there is additional cleaning fees or damage we will recoup these costs from the Participant/Travellers.

What would you like to do?

Please read: We will always do our best to get you doing the activities of your choosing however bare in mind this is subject to availability. Also, a ctivities may be cancelled due to weather, lack of people booked on the activity or even Covid-19!

Where a cancellation occurs and we are notified, we will notify you as soon as we can and see what other activities are similar that you might like.

An activity budget of $750 is included in a 7 day STA trip, where an STA is shorter than 7 days, the budget for activities will be porportionate to your duration.

What activities do you like? and what would you like to do? *

Travel to and from activities

The activities you choose will help us to calculate the kilometre allowance needed for your STA trip. If you have an independent support worker, we will work with them to establish the kilometre allowance.

Food Vouchers/Allowances

Please Note: A food voucher/allowance is a total of $500 for a 7 night stay, if your stay is less or more, your voucher/allowance will reflect the total appropriate to your length of stay.

Any additional expenses outside of your allowance or voucher, is payable by you. Your support worker/s, family and friends should be purchasing their own food.

Restaurant booking arrangements

Would you like us to book any lunch or dinners for you? *

YesNo

We can arrange restaurant bookings for you however your meal and drinks cost will need to be paid by way of the Gift Card provided you. Any cancellation fees for last minute changes or no-shows, will be charged to the Gift Card issued to you.

If yes, where, on what date and on what time?If we don't have all the information we may not be able to book these for you. We need a date and time preference along with the correct restaurant name. Thank you!

Other Important Information

Now we know who is going, where, when and what you would like included; we need to confirm we haven't missed anything important. As well as who we send the STA Quote to for approval before we start to book!

We are nearly there!

Do you have any allergies? *

YesNo

Details of allergies *

Do you need TDC Team Members to assist you with medication?

Yes No

Is any manual handling required? *

YesNo

Is there anything else we should be aware that would help you have an even better trip? *

NDIS Support Team Details

Do you have a Support Coordinator? *

YesNo

Support Coordinator's Name *

Support Coordinator's Email Address *

Support Coordinators Contact Number *

Do you have a Plan Nominee? *

YesNo

Plan Nominees Name *

Plan Nominees Contact Number *

Plan Nominees Email Address *

Are you Plan Managed or Self Managed *

Plan ManagedSelf Managed

If Self Managed, we will send the quote to the email address entered for the Participant at the start of this form.

Plan Manager's Name *

Plan Manager's Email Address *

TDC T & C's

Easy English Terms and Conditions

1. Once we have sent your quote to your Plan Manager or yourself (if Self-Managed) and got the 'a-okay' in writing, we will start to book your STA, at this time some cancellations, change or booking fees and conditions will apply (you can find these on the quote provided).

2. Where there are changes to your STA either by TDC or another service provider (for example, the hotel or activity operator) we will let you know as soon as we can. Sometimes these changes may happen without TDC knowing. Where changes occur that you are not happy with, let us know as soon as you can so we can help you to find a solution.

3. We encourage you and all travellers to understand any travel restrictions that may apply to your booking, these may be COVID-19 vaccination requirements for travelling, staying in the hotel or for participating in activities and going to restaurants. All advice given by TDC is general advice only as these can change at any time. Because of this, TDC isn't responsible for any disruptions to your STA due to change in travel and vaccination requirements.

4. Cancellations within 7 clear business days will still be charged to your plan for any TDC staffing costs. Cancellations at any time from the time of booking may apply to you and will still be billed to your plan. This may be accommodation costs, TDC's booking fee, non-refundable gift cards. Where TDC can get credit's or vouchers for you, we will do so and send these to you after payment of cancellation fees have been made.

5. Our payment terms are 7 days. If you are booking an STA that is quite far in the future, TDC will bill for the components we have been charged for and our booking fee, Support Worker cost will be invoiced after those supports have concluded.

6. TDC is liable for any errors made by us but TDC is not liable for errors made by others.

7. We will give you documentation with your booking details. Please bring this with you when you start your STA. Some travel documents may not be able to be reprinted and may need to be paid for to replace them. So keep your travel documents with you and in a safe, memorable place.

8. Some things in your STA quote are subject to availability, where TDC can hold availability for you, we will. Sometimes we can't though and so before booking anything after the quote is accepted, we will let you know immediately of any pricing or availability changes and get the approval for those.

9. These are some of TDC's Terms and Conditions but not all of them, it's important that you read/understand them all before accepting our STA quote. You may want someone else you trust to explain them to you.

You can find them here: STA Terms and Conditions V2 (snapforms.com.au)

TDC's Full Terms and Conditions have been explained to me or I have read and understand them. I agree to these and wish to continue with my STA Booking *

So, whats next?

We will get busy quoting your STA! We aim to have this to you within 2 clear business days.

If your STA is due to start within 2 clear business days, we cannot guarantee we can get this organised in time for you but will let you know!

If you have any other questions please call our STA Team on 1300 440 274 or send us an email at stabookings@thediversecollective.com.au

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