WIP -Blue EDGE Program Delivery form

WIP -Blue EDGE - Program Delivery Form
Thank you for your recent engagement in signing up for the Blue EDGE program! To help us create a tailored experience that aligns with your goals, please fill out the required details in the form below.

Your responses will allow us to progress in building the program and ensure we meet your specific needs. We’re excited to work with you and look forward to the journey ahead!

Once you have submitted this form one of our Program Coordinators will be in touch to set up a Meeting with you.
Please provide school name:*
Please select from list below, package selected as per the signed Agreement: *
Please select from list below, the Term program is going to be delivered as per signed Agreement*
Provide First preference preferred day of the week*
Select as First preference Start date (Note: Our programs start in week two of each term.)*

MonthDayYear
Date
First preference start time*

Hour Minutes

AM/PM Option
Provide Second preference preferred day of the week*
Select as Second preference Start date (Note: Our programs start in week two of each term.)*

MonthDayYear
Date
Second preference Start time*

Hour Minutes

AM/PM Option
For your attention when selecting you program delivery dates:
Please ensure that you consider any potential conflicts with public holidays, student free days, parent-teacher interviews, sports carnivals, school camps, assemblies, or other school events when selecting your preferred days and times that may coincide with the program.
Kindly provide dates in the space below:
Proposed Cohort:
Please note that Blue EDGE is designed for 20 students across Years 7-9. You can target a specific year level or select students from across year levels.
Proposed cohort- 'specific year level, or, select students from two consecutive year levels, eg. 7/8 or 8/9. Please provide details below
Program Details and Inclusions
Blue EDGE Library - Compulsory Topics - Blue EDGE is an 8-session program (Session 1 - 2 and 7-8 are compulsory). These sessions are:
Welcome to Blue EDGE
Communication & Collaboration
Safety in our Community
Reflection
Blue EDGE Library - Topics to selected from - For Sessions 3-6 you have the option to select 4 topics of your choice. If you are accessing your Mental Health Menu funding, you are required to select the Mental Health and Wellbeing topic.
IdentityHealthy Decision MakingDiversityMental Health & WellbeingAccessing SupportAlcohol & Other Drugs
Program Inclusion

Catering
Catering is included in this package. Meals will be served in the form of small boxes: Breakfast box for morning programs or Snack box for afternoon programs. Please select from the below if you wish for Blue Light Victoria to provide this option or if you will be opting to self-cater.
Next section is only applicable if you have selected Team Day/Fitness/Full package as part of the program. (As per the Signed Agreement) Do not complete this part if you have not signed for this in the Service Agreement. If you have changed your mind and wish to sign up for Team Day or Unlimited Fitness, please contact the Programs Office Programs@bluelight.org.au so that this can be arranged.
Please Indicate if you prefer to select your own place of choice or Blue Light Victoria to finalise on your behalf.
If you have selected School Preference, please provide details of which place you will like for us to finalise as your place to go for Team Day:
Should be Empty:

WIP -Blue EDGE - Program Delivery Form

Program Details and Inclusions

Program Inclusion