2019 Online Group Mentoring Programs
Expression of Interest Form for 2019 Online Mentoring Programs - please complete all questions.

Please Note: This EOI is NOT the registration form.


Technology Required: Access to a device that has both microphone and camera capabilities to access the Zoom platform (link to join the sessions will be sent prior to sessions commencing). Stable internet connection is required.

Cost: $252 for a 6 session program

Dates: All groups commence the week beginning 16th June 2019 running for 6 consecutive weeks

Spaces are limited and whilst we may not be able to offer every applicant a place the current intake, you will be placed on the waitlist automatically and be contacted when a spot becomes available. We offer programs approximately every 8 weeks throughout the year.

Next Steps: You will receive a form submission confirmation and be contacted when a spot becomes available

If you have any further questions, please visit our FAQ section on our website at www.icannetwork.com.au/faqs/
or email online@icannetwork.com.au

You will be notified when a spot is available- please ensure you check your spam folder. Please note due to volume of interests we will contact you when a space becomes available.

Please note that if you have outstanding invoices from previous programs including camp, you need to contact us to settle your open accounts before accessing further programs. This includes includes NDIS and cancellations.

Email address *
Parent's full name *
Your answer
Parent's contact number *
Your answer
Child's full name *
Your answer
Age of child *
Your answer
Location *
Your answer
Has your child participated in Online Group Mentoring previously? *
Current grade/year level at school? *
Your answer
Please select relevant funding source *
Please select your child's preferred communication preference *
Please indicated whether your child currently experiences or has experienced any of the below in the last 6 months? *
Which I CAN Online Mentoring group would your child like to complete a Expression of Interest for? *
If there is more than one time slot for your child's age/cohort, can you be flexible on choice of evening ? *
Is there any information that you would like to share in relation to wellbeing that has not been covered or have any general comments? *
Your answer
A copy of your responses will be emailed to the address you provided.
Never submit passwords through Google Forms.
This form was created inside of I Can Network. Report Abuse - Terms of Service