Community Education Request Form

Please complete the details below to send us an email with your request for training

* indicates required fields

Your First Name*

Your Surname*

Your Email*

Your Organisation*

Your Phone*

Address Line 1*

Address Line 2

suburb*

Postcode*

Who is the training for (e.g social work team, case managers, regional DV network etc)*

How many people will attend? (please note we are unlikely to be able to attend groups smaller than 10) *

What type of activity is this? *

Which format will you use? *

If this is a face to face activity, where will it be held?

What is the date of this event? Or indicate if the date is flexible. *

What is the duration of this activity? and provide the time slot if possible *

Supporting Information

Please tell us about the topics or information area you would like covered in this training? *

Please tell us about the purpose of the training activity (e.g team training, community network event, online information etc)? *

Are you able to pay a speaker's fee for this activity? *

You will receive a follow up from our Community Education Coordinator within 5 business days.