Request for presentation to a group by headspace Lismore

Please take a few minutes to complete the following form.
Filling in this form willl help us make sure we offer you the right kind of presentation for your student group.
If you have any questions or want to talk to us about what we can present to your group, please don't hesitate to contact our Community Engagement team at communityengagement@headspace-lismore.org.au

Presentation Date & Time

DayMonthYearHourMinutesAM/PM Option

School or Organisation

Contact Person

Contact Phone

Contact email

Length of time Allocated for Presentation

Audience Type

Group Size

Year Level/ Age Group

Presentation Space

Technical Stuff: Does the presentation space have...

Why do you want us to present to your group?

Has headspace Lismore Presented to this group before? If so, what was the topic?

What do you hope/ expect the outcomes will be from headspace presenting to this group?

Are you able to provide information on in-school support systems and/ or welfare pathways prior to the presentation date? (This will help us tie our message to the ongoing support structures within your school, could include counsellor times and names, referral pathways and names, peer support programs, welfare teachers, Deputies, Year Advisors etc.) If Yes, please provide details in this section or use the upload button to attach a document to this application.

Which (if any) of the following issues are of particular concern to you with regards to the group in mind? Please select max 2

Any other comments, questions or thoughts?

This form is simply a guide and we welcome new and interesting suggestions to support the wellbeing of schools and services!

Please detail (or attach below) your school's COVID Safety/Management Plan or guidelines.

We are required to have this information to approve our offsite activities

Upload any files you want us to have here.

Upload a File

Thanks for your time, please hit the 'submit' button below and a staff member will contact you soon.

Request for Workshop/Presentation