Community Engagement Request Form: Services & Community Groups

1

Community Engagement

Our Community Engagement Coordinators work part-time hours 3 days a week.

An important part of our role in community is to promote headspace services to young people, parents/carers, schools and other key stakeholders. We are keen to collaborate with services and community groups based on the Gold Coast by promoting headspace services, participating and partnering on activities/events/something cool!

Our priority groups include young men, First Nations, Culturally & Linguistically Diverse, and LGBTIQAP+ young people. Requests for community engagement and participation will be prioritised in relation to those priority groups.

Use this form to learn more about how we can work together and to provide details on your request / idea.

Please note we require at least 4 weeks notice to be able to service your request.

2

How can we work together?

Our key community engagement focus is to promote headspace services and share about how headspace can help, the importance of getting help early and how to refer/access our services.

Event Partnership and Participation

There are a number of ways we can work with you on events/activities/something else cool.

If your service/agency is planning an event, conference, EXPO or activity that has a youth mental health and wellbeing focus, we can attend as headspace representatives to join in and support your activities. We can also host a headspace stall, providing opportunities for community members, services & young people to interact with us. Our stall can include resources about headspace services, other local or national youth mental health resources and merchandise to give away.

We are keen to hear of opportunties to partner with services/community groups on co-located activities and events. This could look like a "pop-up" clinic at our Southport centre or a special workshop series during school-holiday time.

We may also be able to partner with you on organsing and running a community event if it is in line with our priority areas.

Please continue with this Request Form if your query fits with the above criteria

3

Name of Service/Community Group* This field is required.

4

Key Contact Name* This field is required.

First Name

Last Name

5

Key Contact Job Title / Role* This field is required.

6

Key Contact Email* This field is required.

example@example.com

7

Key Contact Phone Number* This field is required.

Area Code

Phone Number

8

Type of Community Engagement Request* This field is required.

9

Are you expecting majority of attendees to be aged between 12 - 25 years old?* This field is required.Please note we will only attend events where this age group is the main audience

YESNO

10

Let us know if you are expecting to reach young people from the following demographics:* This field is required.We will prioritise requests that support us to work with our priority groups. You can select more then one option!

Young men

First Nations

Culturally & Linguistically Diverse

LGBTIQAP+

None of the above

Other

11

Have you run this activity/event before?* This field is required.

YESNO

12

Location of activity/event (if known)

13

Date of activity/event (if known)Please note we require at least 4 weeks notice to be able to service your request

Date

14

If you are running an event, how many people are you approximately expecting?

15

What time are we needed / how long? (if known)

16

If you are hoping for us to run a stall, please let us know if you need us to bring any of the below items:* This field is required.If you are hoping for us to run a stall, please let us know if you need us to bring any of the below items:

Marquee

Table

Nothing, we have you covered!

Not running a stall

17

Give us the details! * This field is required.How would you like us to be involved? Why would you like us there? Have we worked together before? What is attendance like? Who are the other participating agencies/services/community groups?