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   Community Engagement
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What type of organisation is this? *
Name of organisation *
Tell us a bit about what your group/community does?
Location including Eircode
Name of contact person *
Role of contact person *
Phone number *
Website address if applicable?
Email address *
If the contact person cannot be there on the day please nominate another person and include their role and contact number?
Preferred time for information talk *
Time
:
Preferred Date - Please note Tuesday mornings are allocated for the Talks. 
Please give 1 months notice for this event to allow us give adequate notice and make arrangements with the Teac Tom speaker panel. 
MM
/
DD
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Is there access to a projector or screen for a short presentation?
Clear selection
Approximate number of people expected to attend? *
Have any of the attendees been affected by suicide?
Clear selection
Is there any other relevant information we need to know?
If yes, please provide additional details *
Contribution
The minimum contribution for a talk is €520.  This support helps cover the cost of 8 counselling sessions, offering someone the space, support & hope they need to choose to stay & keep going.
Some organisations choose to support this life saving investment by:
   - Collecting a small contribution per attendee, or
   - Organising a simple fundraiser alongside the event.
As Teac Tom relies on fundraising to keep our doors open, we truly appreciate any support in this regard. Every contribution helps us continue providing vital services to those who need them.


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