Deadly Thinking Training Expression of Interest

Deadly Thinking Training

Expression of interest form
Training details

Dates: Wednesday 21st August and Thursday 22nd August.
Please note: you must commit to attending both days to complete the Program.

Time: 9am-1pm each day, followed by a Lunch and Yarn

Where: Ipswich Medicare Mental Health Centre (formerly Head to Health),
Nicholas Street Precinct Level 1, Eats Building, Ipswich
Full name*
Phone number*
Email address*
Age group*

12-1718-2425-3435-4445-5455-6465+
Do you identify as Aboriginal and/or Torres Strait Islander?

AboriginalTorres Strait IslanderAboriginal and Torres Strait IslanderNeither, but I am an ally of the Aboriginal and Torres Strait Islander community
Are you able to attend both Wednesday 21 August and Thursday 22 August, 9am to 1pm?

YesNo
How did you hear about the Deadly Thinking Program Expression of Interest?

Darling Downs and West Moreton PHNWest Moreton HealthKambuOther
How do you think completing the Deadly Thinking Program will assist you in the future, both personally and as a community member?
Would you like to be placed on a waitlist for additional training sessions?

YesNo
All successful expression of interest applicants will be notified by phone and email by Friday 9 August with further details.

Please note that due to a strong interest in this training we may not be able to accommodate all applicants. If you have asked to be placed on the waiting list, we will contact you about future training opportunities.
Data Collection Notice

This form asks for information about you to help us coordinate educational planning and activity.

Your information will be kept safe and secure within Australian-based systems. Your information will remain confidential and will only be used for the purpose stated above. If you have any questions about this survey and the information asked, please refer to our privacy policy including how to contact our Privacy Officer.

Please do not submit any personal or sensitive information, such as health records, financial details, or identifiable personal data, unless specifically requested.
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Deadly Thinking Training

Training details