Scheme participant application

To become a member of Energy and Water Ombudsman Queensland, you need to submit an application.

Read more about:

Complete this online application or contact us on 1800 662 837 for further assistance.

Privacy statement

We collect confidential information on this form as required by the Energy and Water Ombudsman Act 2006 (the Act).

Under the Act, we may provide some information to the public, such as publishing your organisation’s name and website link on our website.

We won’t disclose your personal information to any third party without your consent or unless authorised or required by law under the Information Privacy Act 2009.

Part 1 - Details
Organisation details
Address
Postal address
Same as address
Retail authority
Product
Scheme participant date of effect * The date you’ll start providing services to customers in our jurisdiction.
Part 2 - Contacts Please provide direct phone numbers and email addresses. You must tell us if any of these details change.
Scheme participant contact The person who will update changes to the information below.
Media contact The person we can contact directly during business hours about media related enquiries and community outreach opportunities.
Same as above
Finance contacts The people we can send invoices to for payment (e.g. membership invoices, quarterly advance invoices, half-yearly adjustment invoices and unpaid fee invoices), as well as half-yearly complaint information and budget guidelines.
Primary finance contact
Same as above
Secondary finance contact
Complaint contacts A generic email address for investigation notifications, and contact details of the team leader of your customer service unit, their direct manager and the general manager they report to.
We must be able to contact them directly during business hours if we’re investigating a complaint against your organisation.
Team leader
Same as above
Direct manager
Same as above
General manager
Same as above
CEO (or equivalent) contact
Same as above
Part 3 - Declaration
Declaration *
Date *
Your organisation
Address
Postal address
Same as address
Your details
Complaint contact
Same as above
Finance contact
Same as above
Declaration
Declaration *
Date *