Online Form - Register for Assistance

Covid-19 Neighbourhood Assistance

The Shire of Chapman Valley is aware that Covid-19 has impacted the lives of many vulnerable people in our community. If you need assistance during these uncertain times, please fill in the form below to register for assistance.

Your name:*

Your address:*

Your telephone number:*

Email address:*

What assistance do you require:*

Picking up groceries or essential itemsCollecting and posting mail
A friendly phone callWatering gardens
Putting out binsWalking the dog

Other:*

Type the code from the image:

The code you entered is not valid.

Get Audio Code

Type the code from the image

Latest News

January 14, 2022

Proof of Vaccination Expanded

January 14, 2022

Helping the community set up the ServiceWA app

January 12, 2022

COVID-19 Test Isolation Payment to be introduced

Shire of Chapman Valley COVID-19 Portal

Online Form - Register for Assistance

Latest News

Contact Us

Address