Mindarma and/or QPR – Expression of Interest

The information you provide through this EOI will only be used by Healthier Work to administer your access to these training programs.

About you

First name*

Last name*

Telephone*

Email*

Job Title*

Will you be the ongoing contact officer for this training (i.e. responsible for distributing the training information to staff and driving uptake)?*

Yes
No

Please provide the contact officer’s details

First name*

Last name*

Telephone*

Email*

Job Title*

About your Organisation/Business

Organisation/Business name*

Suburb/city*

State*

Postcode

Please note that Healthier Work can only provide access to this training for ACT based workplaces.

Organisation/Business size*

Sector*

Sector : Something else*

Sub Sector*

Training Interest

Please ensure you have undertaken an assessment of staff interest and likely update of this training before completing this form, as places are limited. You can choose to register for one or both training programs, noting that only non-government workplaces are eligible for Mindarma (for up to 30 employees per workplace).

What training are you interested in?*

Mindarma (mental fitness tool)
Question, Persuade, Refer (suicide prevention training)

For the Mindarma training request, how many employees are ACT based?*

For the Question, Persuade, Refer (suicide prevention training) training request, how many employees are ACT based?*

How did you hear about the Mindarma training?

Healthier Work website
Healthier Work social media/e-newsletter
Internet search
Word of mouth
WorkSafe communications/event
Other

How did you hear about this QPR For Business training?

Healthier Work website
Healthier Work social media/e-newsletter
Internet search
Word of mouth
WorkSafe communications/event
Other

If ‘other’, please specify:

Mindarma and/or QPR – Expression of Interest

About you

About your Organisation/Business

Training Interest

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