Expression of Interest

Preffered Name*

Email Address*

Contact Number

Where in the world are you?

Program of Interest

If you feel comfortable sharing are there any other medical or social stuff that I might need to be aware of. For example, you might not like loud noises or have difficulty weight bearing or you have anxiety or just feel a little shy when you first meet people.

Have we met before? If not, I ask that we schedule a discovery call at no charge so I can get to know you better and so that you are comfortable in these sessions?

If you were a vegetable, what would you be?

Do you like music? What is your favourite music/ musician? What is your favourite song at this moment/today?

What do you like doing, what are your interest or hobbies?

Is there anything else you would like me to know about you?

What is your vision condition and your visual acuities? Acuities relates is the fraction that you receive from the eye doctor. This is away for me to understand how clear your vision is. An example of this fraction is 6/60.

Do you like technology?
YesNoA Little Bit

What technology do you use and like?

What would you be logging the zoom call on? Computer? Phone? Ipad?

Can you think of a question that you would like to ask me about me or the program?

Guardian (if applicable)

Guardian Contact Number

Guardian Email Address

NDIS Number

How is your plan managed?

Any Other Questions?

Expression of Interest

Like sneaking peas into a lasagne, our approach is learning through fun and connection.

We will endeavour to be in touch within the next 48 hours to confirm your registration. For any further enquiries please email us or call 0400 000 000.

Participant Registration