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Registration for
Securing the Good Life with Inclusive Education
This is an online self-directed workshop.
Please note this workshop is for family members of students with disability
Your Contact Details
Your Name
*
First name
Last name
Your Primary Email Address
*
Confirm Your Primary Email Address
Your Address
*
Address line 1
Address line 2
City/Suburb
State/Territory
Postcode
Phone
*
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A Little About You
Are you of Aboriginal or Torres Strait Islander origin
*
No
Prefer not to say
Yes
Are you from a culturally or linguistically diverse background?
*
No
Prefer not to say
Yes
Are you a person with a disability
*
No
Yes
Are you a family member of a person with disability?
*
No
Yes
Do you or your family member have NDIS funding?
*
No
Yes
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A Little About the Person with Disability
It can be helpful for us to know a little about your family member with disability. We invite you to provide some information below, however this information is not compulsory.
Your family member's First Name
Your family member's Last Name
What is the relationship of this person to you?
Brother
Child
Other
Parent
Self
Sibling
Sister
Date of Birth
School Year of the person with disability (if applicable)
P
K
1
2
3
4
5
6
7
8
9
10
11
12
If you wish to provide details for other family members with disability please do so here.
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Your access needs
Please provide details of any access requirements to enable your full participation
Confirm your registration
Please check the box below to confirm your registration for this event:
Securing the Good Life with Inclusive Education
*
How did you hear about this workshop?
Please tell us how you heard about this workshop. For example, Imagine More's newsletter or website, your school newsletter or inclusion team, from a friend or colleague etc
*
Imagine More newsletter
Imagine More email
CDNet
School newsletter
Facebook
Word of mouth
Other (please tell us more below)
Please provide any further information about how you heard about this event
We provide regular updates about events and other happenings at Imagine More. Please let us know if you wish to receive newsletters from Imagine More.
*
Please send me newsletters/already receiving newsletters
Please DO NOT send me newsletters
Important!!!
After you submit this form you'll receive a confirmation email with further details about how to access the workshop.
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Please check the highlighted fields
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