Am I eligible for a NILS loan? Complete the form below to find out if you might be eligible for a No Interest Loan (NILS). Form PERSONAL DETAILSFIRST NAMELast NameEmail PhonePost CodeELIGIBILITY DETAILSWHAT IS THE LOAN FOR?Car repairs or car relatedComputer (if school related see below)FridgeFurnitureMedical or dental expensesMobile phoneSchool-related expenses e.g. laptop uniformWashing machineOther - Loan Item not listedDO YOU HAVE A HEALTH CARE OR PENSION CARD?DO YOU HAVE A HEALTH CARE OR PENSION CARD?YesNo (If no, see next question)IF WORKING, WHAT IS YOUR ANNUAL INCOME (AFTER TAX)?IF WORKING, WHAT IS YOUR ANNUAL INCOME (AFTER TAX)?Not workingUnder $45,000 (single person)Over $45,000 (single person)Under $60,000 (couples or people with dependants)Over $60,000 (couples or people with dependants)HOW LONG HAVE YOU LIVED AT YOUR CURRENT ADDRESS?HOW LONG HAVE YOU LIVED AT YOUR CURRENT ADDRESS?Less than 3 months3 – 6 months6 months or moreDO YOU HAVE CAPACITY TO REPAY THE LOAN?DO YOU HAVE CAPACITY TO REPAY THE LOAN?YesNoHOW DID YOU HEAR ABOUT NILS?HOW DID YOU HEAR ABOUT NILS?CentrelinkCommunity OrganisationFinancial CounsellorGoogle searchInternetNewspaperOther government organisationPosterRadioTVWord of mouthOtherView Privacy Policy* I agree that the information I have provided is true and accurate* * I have reviewed, understand and consent to the Privacy Policy*