Register for an Information Session
Access and Inclusion Advisory Committee Expression of Interest
Full Name
*
Email Address
*
Phone Number
*
Which Information Session will you be attending?
*
Please Select
Foster - Tuesday 9 April 2.00pm to 3.30pm
Leongatha - Thursday 11 April 1.00pm to 2.30pm
Online - Monday 15 April 6.00pm to 7.30pm
Korumburra - Wednesday 17 April 5.00pm to 6.30pm
Mirboo North - Wednesday 24 April 12.30pm to 2.00pm
Will you bring a support person?
*
Yes
No
Support Person Full Name
Support Person Email Address
Support Person Phone Number
Do you have any of the following accessibility requirements?
*
Wheelchair access
Access to hearing loops
Access to an interpreter
Bringing a support person
Other (please specify)
Do you have any dietary requirements?
*
Yes
No
Please let us know what your dietary requirements are.
Submit
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