Education Session booking form Education Session booking form Organisation Name * Contact Name * Phone * Email Address of Session * Date of Session * Time of Session * Estimated Number of Attendees * Audience * Aged Care Residents Aged Care Relatives Carers & Under 65’s receiving HACC Services Community Members / Groups Staff Health Professionals Access & Navigation to Age Care (ACSN) Other Special Needs Groups CALD Aboriginal and Torres Strait Islander Rural or Remote Financially or Socially Disadvantaged LGBTQI Veterans and Widows or Widowers of Veterans Care Leavers Homeless of at Risk of Homelessness Will you provide a space that is free of interruptions and other activities including food preparation? * Yes No Will you provide AV equipment for us to provide a PowerPoint presentation? * Yes No Is parking available for the presenter? * Yes No Comments reCAPTCHA If you are human, leave this field blank. Submit