Request for presentation to a group by headspace Lismore

Request for Workshop/Presentation
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...

ProjectorComputer/ LaptopAudio (for video)Microphone (If a large space, or noisy outdoor area)Internet access
Why do you want us to present to your group?

Want the group to gain general information and awarness of mental health and help-seekingHave specific concerns about this group I would like addressed
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

Introduction to headspace and Mental HealthResilienceunderstanding stress and anxietyalcohol and other drug usetips for a healthy headspaceLGBTIQSB+ diversity
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
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Request for Workshop/Presentation