Registration Form

Registration Form

Enter your details below to learn more about the Connecting Seniors and Carers Program and stay informed about upcoming activities, events and opportunities to participate.
Whether you’re a senior, a carer for a senior family member, friend or neighbour, a service provider, or keen to volunteer, we’d love to hear from you.

We’re working with our community to identify gaps in care, services and support for seniors and their carers. Your insights will help us shape a free Connector service that simplifies the process of finding, accessing and navigating local support and the service system, making it easier for seniors and carers to connect with what they need.

There are many ways to get involved -
- sharing your ideas and helping shape the program
- participating in activities
- accessing support through the service
- volunteering to assist with admin tasks, events, helping connect people with appropriate services or providing support to a senior and their carer.
Together, we can build a more connected, informed and supportive community where seniors and carers can access the right support more easily and live well.
For the purpose of this program:
- 'care' can include, but is not limited to, assistance with daily living, such as meal preparation, personal hygiene, garden and home care, medication management and transport, as well as emotional support. The level of care can range from a few hours of assistance each week through to 24/7 support.
- a 'senior' is defined as someone aged 60 years or older, or 50 years or older for Aboriginal and/or Torres Strait Islander people; and
- a 'carer' is defined as a family member, friend or neighbour of any age who provides personal care, support or assistance to a senior who is living with a disability, managing a chronic or terminal condition or is frail and aged. A carer in this context is someone who provides care out of a personal relationship with the senior rather than through a formal employment contract or paid healthcare role. A carer is eligible to receive support through this program even if they receive a Carer Allowance or Carer Payment.
Full Name

First NameLast Name
Email Address
example@example.com | If you do not have one, please type NoReply@sncc.org.au
Phone Number
Mobile phone number preferred to enable text/SMS communications.Format: (000) 000-0000.
Residential town or village
Postcode
Select your age bracket
Are you of Aboriginal and/or Torres Strait Islander origin?
Select the answer that best represents your current circumstances. (Refer above for 'senior' and 'carer' definitions before answering.)

Other
I would like to find out more about: (Tick all that apply)

Other
Help us design services or activities that will help to address your unmet needs or areas of greatest challenge for you as a senior or carer. What topics would be most useful or interesting to you?
By submitting this form, you consent to Springwood Neighbourhood Centre (SNC) collecting, storing and using your information to contact you from time to time about the Connecting Seniors and Carers Program and other SNC-led community programs. We will keep communications to a minimum and only share updates, events and opportunities we believe may be relevant to you. You can unsubscribe from our communications at any time.

Your personal information captured in this form will be kept confidential and will not be shared with third parties unless required by law.
Consent and acknowledgement
Please verify that you are human
Form last updated: 08/09/2026
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