Given Name
*
Family Name
Email Address
*
Phone number
*
Suburb / Town
Your gender
*
Male
Female
Non-binary
I use a different term
I prefer not to say
Do you identify as
*
Aboriginal
Torres Strait Islander
Both
Neither
I prefer not to say
What is your main language(s) spoken at home?
Choose your closest location
*
Bendigo
Ballarat
Warrnambool
Choose a workshop in Warrnambool
*
Circle of Security Parenting - Tuesdays, 11 Feb - 1 Apr
Living with Teens - Thursdays, 6 - 20 Mar
Choose a workshop/program in Bendigo
*
Building Resilience in Kids - 19 Mar
Circle of Security - 13 Feb - 20 Mar
Parenting Together - 1st & 8th May
Tuning in to Kids/Teens Booster - 1 Apr
Tuning in to Kids - 20 Apr - 10 Jun
Tuning in to Teens - 1 May - 12 Jun
Bringing Up Great Kids - express your interest
My Kids and Me - express your interest
Choose a workshop/program in Ballarat
*
Connecting with Kids - 18 Mar
Tuning in to Kids - 30th Apr - 11 Jun
Bringing Up Great Kids - express your interest
Age of your child/children? (select all that apply)
*
0-3yrs
4-8yrs
9-12yrs
13-17yrs
18yrs+
How did you hear about us?
Web / Google search
Referral
Social Media
My workplace
My TAFE / university
Word of mouth
Other
Let us know how you heard about us
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