Presentation or workshop request form

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 *

First Name Last Name
E-mail *
Mobile Number

Phone Number
Phone Number *

Area code Phone Number
Organisation/school name *
Engagement type *
Ideal date of engagement *

Day Month Year
Date
Ideal time of engagement

: Hour Minutes AM/PM Option

Address *

Please tell us a bit about your event? What are you hoping to get out of having headspace Hawthorn attend? *
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
What tech equipment is available?

Projector with working sound Projector without sound Clicker for projector Laptop (for USB port) Microphone (for large audiences)
What setting is the presentation/workshop taking place?

Classroom Auditorim/lecture theatre Hall/Gym Clubrooms
Additional information
Should be Empty:

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Community engagement request form