Community engagement request form
Please note we require at least 2 weeks notice before your ideal date. Completing this enquiry form does not confirm your event. You will hear back about your request within 7 working days.
Contact person
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First Name
Last Name
E-mail
*
Mobile Number
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Phone Number
Phone Number
*
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Area code
Phone Number
Organisation/school name
*
Engagement type
*
Please Select
Presentation
Workshop
Ideal date of engagement
*
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Day
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Month
Year
Date
Ideal time of engagement
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
05
10
15
20
25
30
35
40
45
50
55
Minutes
AM
PM
AM/PM Option
Address
*
Street Address
Street Address Line 2
Suburb
State
Post code
Please tell us a bit about your event? What are you hoping to get out of having headspace Hawthorn attend?
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Would you like headspace Hawthorn to help promote your event/activity?
Yes
No
Number of people expected to attend
*
Who will be present at your event?
*
Young people (aged 12-25)
Children (aged 0-11)
Parents
Community members
Staff (includes teachers)
Coaches
Will there be any young people with additional learning or access needs? e.g. disability or language barrier
*
Is there free parking available on site? If so, where?
*
Presentations & workshops
The following questions relate to presentations and workshops. Please see the 'Presentations by headspace Hawthorn' flyer for more info on presentations. Keep scrolling for questions about info stalls.
Presentation topics (30 mins)
Keeping a healthy headspace
How to ask: RUOK?
Managing stress
Tackling body image & self esteem
Understand gaming
Alcohol and other drug safety
Greif and loss
Bullying
Other
What tech equipment is available?
Projector with working sound
Projector without sound
Clicker for projector
Laptop (for USB port)
Microphone (for large audiences)
Other
What setting is the presentation/workshop taking place?
Classroom
Auditorim/lecture theatre
Hall/Gym
Clubrooms
Other
Additional information
Submit enquiry
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