Family & Friends Reference Group
headsapce Mount Gambier Family & Friends Reference Group application
Thank you for applying to be part of the headspace Mount Gambier Family & Friends Reference Group!
Click 'start' if you're ready to apply to be a part of something awesome!
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1.
What is your name?
2.
Contact information (Email, Phone Number, Address, Suburb, Post Code)
*
3.
Are you family member or friend of a young person who has been supported by headspace?
(Required.)
Yes
No
4.
Is this something you would be happy and feel comfortable to talk about?
Yes
No
5.
Do you speak any languages other than English at home?
No
Yes - please specify
6.
Where were you born?
7.
Do you identify as Aboriginal or Torres Strait Islander?
Yes
No
*
8.
Please describe what skills or ideas you would bring to the Family & Friends Reference Group
(Required.)
9.
Are you involved in any other organisations?
If yes, please describe which organisations and your involvement.
Yes
No
Other (please specify)
10.
Which timeslot would you be available to participate in meetings?
Weekdays AM
Weekdays PM
Weeknights
Current Progress,
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