headspace Geelong Education Request

headspace Geelong Education Request

To request an education session delivered by headspace Geelong please fill out the form below
Key Contact Name*

First NameLast Name
Position
School/ Organisation
E-mail*
Phone Number*

Area CodePhone Number
Presentation Booking

If you are booking for more than one class/group please ensure all classes can be scheduled into one day.
1st Preference Date/Time of request*

DayMonthYearHourMinutesAM/PM Option
2nd Preference Date/Time of request*

DayMonthYear
DateHourMinutesAM/PM Option
3rd Preference Date/Time of request*

DayMonthYear
DateHourMinutesAM/PM Option
Address where education session will be delivered*
Number of classes/groups
Average number of participants per group
Year level of students/ age of young people
Number of teachers/staff present & engaged in session
Type of education session

What is headspace Geelong (Service Explanation) (25-30mins )Mental Health overview +What is headspace Geelong (50mins)Looking After Yourself and Your Friends
Please detail why you are requesting for headspace Geelong to deliver this education session to your school
***** Educations sessions are provided free of charge, however, donations are greatly appreciated where possible. To donate please head to our lead agency's, BCYF's, website https://www.bcyf.org.au/get-involved/donate/donation-in-dollars *****
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Presentation Booking