Request Form - presentations/events
Thank you for inviting headspace Mildura to your school/organisation.  We will try to accommodate your request; in order to plan, provide staff, information and resources we ask that you give a minimum of 4 weeks’ notice prior to your requested date. Please note that staff in these roles work part time (Tuesday, Wednesday, Thursday), however requests outside of these days will still be considered depending on other staff availability.

Please complete one form per presentation/workshop/event

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Name of School/Organisation *
Please nominate one key contact for your school/organisation that will manage this request (name, position, email, phone contact) *
Date requested *
YYYY
/
MM
/
DD
Is there any flexibility with your date requested? *
Time requested *
시간
:
Location & is internet available *
Audience age group and approx. number of participants: *
Name/s of staff attending: *
Presentations/workshops on offer *
If you would like headspace Mildura to attend an event please indicate below.
Please comment below if you are requiring an information stall or interactive activities for the above event.
The expected outcome (s) of headspace Mildura's attendance
Are there any issues/incidents which headspace Mildura should be aware of before attending? *
Thank you.  headspace Mildura will be in touch to discuss the outcome of your request.
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