GPAN Project Application Form
Please note, places for GPAN training in 2025 are limited. This form is an expression of interest.

WHEN: Wednesday,July 30th 2025 from 6.00pm-8.30pm
*sessions are weekly for 6 weeks

WHERE: Banksia Gardens Community Services
71-81 Pearcedale Parade, Broadmeadows

COST: Free
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YOUR DETAILS
First name *
Surname *
Date of birth *
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DD
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Gender *
Preferred pronouns (e.g. she/her, they/them, he/him) *
Email address *
Mobile phone number *
Have you been vaccinated against COVID-19? *
Are you currently studying/employed? *
Where are you currently enrolled/employed? *
Residential address *
Photographic consent? *Photos and films will be used solely for documentation and promotional purposes *
Dietary requirements *
Do you have any allergies, medical conditions or disabilities we should know about?   *
EMERGENCY CONTACT
Full name of emergency contact *
Contact number *
Relationship to you *
FOR THOSE UNDER 18 YEARS OF AGE
Parent/guardian permission for young person to participate in the GPAN project
Parent/guardian name
Relationship to participant
Contact number of parent/guardian
Consent granted for the young person to participate in the GPAN Project
Clear selection
A BIT ABOUT YOU
What do you hope to learn during the six-week GPAN training program? *
What do you hope to gain from your GPAN volunteer experience? *
How did you find out about GPAN? *
Why did you sign up to GPAN training? *
Tell us a bit more about you *
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