HEY Social Group - 2026 - EOI

  • LGBTQIA+ and Neurodiverse Social Group

    Expression of Interest

  • Please note this is an application form for the LGBTQIA+ and Neurodiverse group only. You will be contacted by one of the facilitators before joining the group.

    headspace Ballarat’s LGBTQIA+ and Neurodiverse social group is a safe space for queer and neurodivergent identifying young people aged 12 - 17 years old to build friendship and connect with others.

    Founding members of the group will name the group and work with the facilitators to plan fun activities the group will do each week

    Group meets on Wednesday March 4th, 11th, 18th, 25th and April 1st from 4pm - 5:45pm at headspace Ballarat, 20 Dawson Street North, Level 1.

  • Young person details

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  • Emergency contacts

  • Please provide contact person/s in case of an emergency, including any information you would not want us to disclose to an emergency contact.

    (e.g. sexuality, gender identity, pronouns).

  •  Person 1

  •  Person 2

  • Code of conduct

  • Group Code of Conduct

    To keep the group a safe and inclusive space for all the following conduct guidelines must be followed by all members:

    • I will be inclusive and respectful of others.
    • I will be kind and considerate to the diverse ways in which we communicate.
    • I will not pressure anyone to share any personal information they do not want to share.
    • I will be patient with those who are still learning or willing to learn
    • Do not be afraid to ask questions – this is how we learn
    • Everything spoken about during group should remain private and confidential – I will not use any group members name or other personal details when talking or sharing stories outside of the group. Group is a safe space and not all who attend the group are publicly out to family/friends.
    • The group facilitator’s work mobile is only accessed Monday – Wednesday, 9am-4:30pm. The mobile is used to contact Group members about meetings and activities. Only contact the facilitators work mobile in response to the facilitator or for matters relating to the Group. The mobile is not to be contacted in emergency or crisis situations.

     

    Problem Solving

    If you have any problems in the group, please let the facilitator know and they will help you.

    headspace Ballarat can remove any members from the group who are not following the Group Code of Conduct.

     

    Care and Support for Group Members

    headspace Ballarat promotes early intervention and help-seeking for mental health and drug and alcohol issues. It is important if you (or another group member) are feeling mentally unwell or are in a crisis situation and believe that you are at risk to yourself or others, that you contact a trusted adult or an appropriate support service to get the right help. These services and their contact details are listed below:

    Regional Triage/Psychiatric Services (24/7)– 1300 363 788

    Police or Ambulance (24/7 and complete welfare checks or transport to hospital)– 000 

    Lifeline (24/7)– lifeline.org.au or 13 11 14

    Kids Helpline (24/7)– kidshelp.org.au or 1800 55 1800

    eheadspace (7 days, 3pm-10pm)– eheadspace.org.au or 1800 650 890

    Qheadspace- online

    Rainbow Door- rainbowdoor.org.au or 1800 729 367

    headspace Ballarat– 5304 4777 (not a crisis service)

     

    I have read the information above and agree to abide by the Group Code of Conduct.

  • Clear

  • Parent or Guardian consent

  • headspace Ballarat requires parent or guardian concent for young people aged 15 and under to attend our survices.

    Please provide an email adress and phone number of a parent or guardia to fill out the concent form. The form will be sent to the provided email and will need to be completed before you can join the group.

  •  Click the Submit button below to complete.

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