Thank you for your interest!

This form is most compatible with a computer rather than your iphone / tablet.

If you are having any problems with this form, feel free to contact us on 03 9510 1188 or via email – reception@chameleon.net.au

Please complete the form below & upload your photo to register your interest.

If you are applying as a couple, please make sure to complete just ONE form and upload a photo of the BOTH of you together.

Thanks!

Name: *
Mobile Phone: *
E-mail: *
Age (and if applicable, your partners' age): *
Do you have any children?: *
If YES, please let us know the age and gender of your children:
Upload a Clear & Recent Photograph of yourself: *
Any other additional comments: