EYDN Co-Design Expression Of Interest

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At EYDN, we involve people with lived experience of disability in our work as much as we can and give them a voice. We need your voice and opinions for some new projects that we are designing through a process called co-design.

Please complete this survey if you would like to be a part of some new co-design groups being held by Enabled Youth Disability Network (EYDN) in collaboration with JFA Purple Orange.

You will be given the choice to select the co-design group that best fits your lived experience. The metropolitan co-design group will assist in the design of our ongoing peer-support meetings, and the design of a new peer mentoring school program. The regional co-design group will assist in the design of some new workshops that will be rolled out across some regional areas.

For more information on the co-design role, please click here. For an Easy Read version, please click here.

We will not share your details with anyone outside of EYDN or JFA Purple Orange.

We will try to give as many people as possible the ability to participate in the co-design groups, but due to limited capacity, please do not be offended if we cannot select you, and we thank you for wanting to support EYDN. Please feel free to indicate that you would like to be considered for future opportunities to work with us, and we will be in contact.

If you have any questions, or require any modifications to be able to complete this form, please contact Sarah Footner at sarahf@purpleorange.org.au, or (08) 8373 8388.

Email *

Name: *

Are you interested in the Regional or Metropolitan co-design group? *

Regional

Metropolitan

Postcode:

Phone Number:

Age:

Gender:

Female

Male

Non-binary

Prefer Not to Say

Other:

Clear selection

Are you Aboriginal or Torres-Strait Islander?

Yes

Clear selection

Do you live with a disability?

Yes

Clear selection

What kind of disability do you live with?

Intellectual Disability

Physical Disability

Autism

Aquired Brain Injury

Neurological Disorder

Blind or Low Vision

Deaf or Hard-Hearing

Deaf-Blind

Speech Loss or Impediment

Psychosocial Disability/ Mental Illness

Prefer Not to Say

Other:

Do you have a family member living with disability?

Yes

Clear selection

What kind of disability does your family member live with?

Intellectual Disability

Physical Disability

Autism

Aquired Brain Injury

Neurological Disorder

Blind or Low Vision

Deaf or Hard-Hearing

Deaf-Blind

Speech Loss or Impediment

Psychosocial Disability/ Mental Illness

Prefer Not to Say

Other:

How old is your family member?

Do you have any accessibility requirements (eg. an interpreter, translator, support worker present, guide dog) that we should be aware of to help you participate in the meeting?

How would you like to receive future communication for the co-design group?

Phone

Text Messaging

Clear selection

Would you prefer to receive documents (such as agendas), before the meetings?

Yes

Clear selection

Are there any other modifications you need to the documents to help you participate in the meetings (eg. Easy English versions, increased font size, translation)?

What is your availability during the week?

Have you worked with EYDN or Purple Orange before? (E.g. as part of a co-design group or focus group). If yes, please describe.

Would you like to be considered for future opportunities (eg. focus groups, co-design groups) to help support EYDN? We will contact you as opportunities arise.

Yes

Clear selection

Is there anything else you would like to tell us about your interest and ability to work with Purple Orange?

Send me a copy of my responses.

Submit

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