CV Membership

Please complete this form for Carers Victoria's Carer Support Group membership and online Carer Support Group directory.
cid
About your Carer Support Group
Carer Support Group Name*
Are you*

Adding a new groupUpdating an existing group
Please provide an Introduction paragraph about your group (maximum 100 words) *
Who is your group for? What type of carers who may attend your group? Please select all relevant*

All Carers welcomeDisabilityAgedMental IllnessChronic IllnessYoung CarersWomens GroupMens GroupParentsCultural GroupLGBTIQA+Aboriginal and/or Torres Strait Islander
What activities does the group undertake throughout the year? *
Different groups meet in different ways, use this field to let prospective members know what to expect if they join your group.
Is there a cost to attend your group?*

YesNo
If yes, please specify what costs are involved:
For Example - $10 per meeting
Can the person I care for attend the Carer Support Group meetings with me?*

YesNo
Group Details

This information will be published online if you have consented to join our Carer Support Group Directory.
Group Email *
How can your group be contacted?
Group Phone number (if applicable)
How can your group be contacted?
Group website (if applicable)
Group social media (if applicable)
Primary Contact Details
Primary Contact First Name*
Who is the best person to contact about your group?
Primary Contact Last Name*
Primary Contact Email *
This information will NOT be published online unless it is the same as the group email provided above.
Primary Contact Phone number
This information will NOT be published online unless it is the same as the group email provided above.
Is your Group contact / facilitator paid / employed to run your group?*

Paid / employed contact / facilitatorVolunteer contact / facilitator
Group Meetings
How many members in your Carer Support Group?*
Where does your group meet?*

In personOnlineIn person and online
Group meeting day and time*
Eg. Fortnightly Thursday - 10am - 12pm
Meeting Address Line 1
Address where your group meets
Meeting Address Line 2
Meeting Suburb
Meeting State
Meeting Postcode
Does the location where you meet have wheelchair access?

YesNo
How did you hear about Carers Victoria's membership?
Should be Empty:

About your Carer Support Group

Group Details

Primary Contact Details

Group Meetings