Cliq Connection
Sign-Up Form

Once we receive this form we will commence onboarding the user onto the Cliq Connection app. The user will then receive an email with their login details. The participant will need to download the app from the

Pricing & Payment Options

You can access The Cliq Connection in two different ways:

1. NDIS-funded learning (includes free app access)

Each learning module is $90 for 3 months’ access
Usually funded from Capacity Building – Skills Development in your NDIS plan
When you pay for The Cliq Connection Learning with NDIA funding, you receive access to The Cliq Connection app for free

2. Privately funded app-only access (no learning modules)

Pay $7.99 per month
This payment is out-of-pocket (not NDIA funds)
Payment is made directly through the Apple App Store or Google Play Store
This option gives you access to The Cliq Connection app only and does not include the learning modules

Once we receive your NDIS funding details for the learning modules, we’ll start onboarding you to The Cliq Connection app.
You’ll receive an email with your login details, then you can download the app from the Apple Store or Google Play Store and log in.

Service Agreement

I want to pay for the Cliq Connection App from

My personal money $8 per month paid through the app
My NDIA Funds (Cliq Connection Learning $90 for 3 months access to learning and app)

You are agreeing to the service agreement linked above which indicates that we will be invoicing for Cliq Connection Learning at $90 for 3 months of access to your nominated plan manager. Please note - we are not NDIA registered and unable to use funding to pay if your are NDIA Managed.

First Name *

Last Name *

User Mobile Number *

This will need to be available as your verification code will be texted to this number.

User Email *

This is where verification emails will be sent.

Date of Birth - You must be over 18 years of age to join. *

Identity/Gender *

State *

Suburb *

NDIS Number *

Your NDIS Funding - Are You Self Managed or Plan Managed? *

Where should we send the invoices? *

If someone else manages your invoices, please add their email here.

Where should we send the invoices? *

Your Plan Manager's Name / Email

Additional contact

Support worker, Support Coordinator or Family member

Additional contact Phone

Contact's relationship to the user

Additional contact Email

How did you hear about us? *

If you have a Promo code, add it here:

What are you looking for? *

Does the participant have a conviction for Domestic Violence or Sexual Assault? *

What is important to you? *

150 characters

Are you looking for a relationship with? *

Tell us about yourself *

150 characters

Are you looking for a friendship with? *

Referral form and Agreement.

Signature *

Clear Signature

81795

Cliq Connection Sign-Up Form

1. NDIS-funded learning (includes free app access)

2. Privately funded app-only access (no learning modules)

Cliq Connection
Sign-Up Form