Community Connector Application Form

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Thank you for your interest in the DPV Health Community Connector Program!

The Community Connector Program brings together passionate community representatives from across Hume and Whittlesea for an 8 week leadership program for people with a passion to build their skills and the health knowledge in their community. The training is 8 1.5 hour online sessions from November 2020– January 2021.
For more information please see the Community Connector Position Description.

Applications close November 10 and will be assessed upon submission.

First name *

First name

Last name *

Last name

Email *

Post Code

Phone number *

Why would you like to be a DPV Health Community Connector?

Please describe your experience with community groups or community organizing to date.

Are you able to commit to attending 8 training sessions on a Thursday evening from November 2020 - January 2021?

Yes

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Do you speak a language other than English? If so, please list them.

Do you identify with any of the following groups (you can select more than one)?:

Refugee, asylum seeker or culturally diverse background

Living with a disability

Aboriginal and/or Torres Strait Islander

LGBTIQ+

Under the age of 25 years

Submit

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