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Voices in Action - Create Conference Expression of Interest Form
14th - 16th November 2019
Melbourne Zoo
Tickets will be purchased by Carer KaFE
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* Indicates required question
Full Name
*
Your answer
Email Address
*
Your answer
Phone Number
*
Your answer
Postal Address
*
Your answer
Are you a..?
*
Choose
Formal Kinship Carer
Accredited Foster Carer
Other
Which agency are you with?
*
Your answer
What is your case manager's name and email address?
Your answer
Are you Aboriginal and/or Torres Strait Islander?
*
Yes
No
Prefer not to respond
Are any of the children in your care Aboriginal and/or Torres Strait Islander?
*
Yes
No
Unsure
Do you have any dietary requirements?
*
None
Vegetarian
Vegan
Halal
Kosher
Shellfish allergy
Nut allergy
Lactose Intolerant
Gluten free
Other:
Required
Have you attended a camp or conference with Carer KaFE in the past?
*
Choose
Yes
No
Tell us how attending the Voices in Action - Create Conference (Melbourne) would benefit the children in your care and yourself as a carer?
*
Your answer
Will a child or young person be attending the conference with you?
*
Yes
No
Unsure
Required
Do you wish to attend the Evening event?
*
Yes
No
Required
Emergency Contact Name:
*
Your answer
Emergency Contact Phone Number:
*
Your answer
Emergency Contact Relationship to you:
*
Your answer
Alternate number:
*
Your answer
How did you hear about this conference?
*
Carer KaFE Website
Carer KaFE Facebook
Carer KaFE Online Newsletter
Carer KaFE Postcard
Foster Care Association of Victoria
Kinship Carers Victoria
Your Agency
DHHS
On the radio
Word of mouth
Other:
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