Conversation Convoy - Expression of Interest

Your name*

First NameLast Name
Organisation/School/Community Group*
Position/Role *
E-mail*
Mobile Number*
e.g. 0400 111 111
City/Suburb*
Postcode*
State*
How did you hear about the R U OK? Conversation Convoy?*

Local Media (TV/Newspaper/Radio)Social MediaSaw the convoy in my townWord of mouthOther
Are you interested in a full activation or a workshop? *
How could you help stage a successful event? (think about location, attendance, contacts within the community)*
Are there any existing events in your area (such as festivals or shows) that might be relevant for R U OK? to attend? If so please provide the name, date and details of the event.*
Are there any specific community needs we should consider in our planning e.g., Aboriginal and Torres Strait Islander peoples, community members who speak a language other than English, etc.
Why do you think it is important for the R U OK? Conversation Convoy to visit your community? *