Organisation Registration Form - Connect and Thrive Pathways
26th November | Murwillumbah Civic and Cultural Centre | Auditorium
About you
Name
*
First Name
Last Name
Email
*
Phone Number
*
Organisation Name
*
Is your organisation known by a different name in your community or in advertising and promotion?
Tell us below or leave it blank if its the same as the company name.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Organisation website
Social media platforms
Does your organisation have current or future opportunities for young people?
*
Yes
No
If you selected yes, please provide details of your current or future opportunities for young people
*
Please provide 2 sentences about the role your organisation/business plays in the community.
*
This information will be used on a handout for attendees
Do you agree with your contact details being shared with young people?
*
Yes
No
Other
Do you have a career journey experience that you would like to share with young people?
*
Yes
No
Other
If you attend, you will be provided catering. Do you have any dietary requirements?
*
Yes
No
Please provide details of your dietary requirements
*
Submit
Should be Empty: