Registration Form- Future Planning Workshop taking place on Thursday, 9 November 2023

 
First name*
 
 
Last name*
 
 
 
Age*
 
 
Phone number*
 
 
 
Email address*
 
 
Postcode*
 
 
Are you registered with Carer Gateway?*
 
Yes
No
 
 

If you answered no and are a carer living in the Central Coast, Hunter New England or North Coast regions of NSW and would like to register with Carer Gateway, please call 1800 422 737 Monday – Friday 8.00am to 5.00pm and select option one to speak with your local service provider. Alternatively, you can visit www.carergateway.gov.au/request-call-back to request a call back and begin the registration process with your local Carer Gateway provider.

 
 
The following questions are optional  
 
Are you of Aboriginal or Torres Strait Islander origin?
 
Yes
No
 
 
Are you from a culturally and linguistically diverse background?
 
Yes
No
 
 
*The term culturally and linguistically diverse is commonly used to describe the diversity of language, religion, culture and ethnicity of people living in Australia.  
How did you hear about this session?
 
 
 
 
Other please specify
 
 
 
 

Privacy collection notice

By registering for this event and providing your personal information you are consenting to us collecting and storing this information on our database in order to comply with our legal and reporting requirements. Any statistical data provided is de-identified.

All information collected is stored and used in accordance with our Privacy Policy which contains details of how you can access or correct the personal information we hold about you. It also contains information about how you can complain about a breach of the Australian Privacy Principles.