The SEED Project - Expression of Interest

Sustaining Economic Empowerment and Dignity for Women in Seymour, Victoria.

Our hub aims to provide a safe space for the women of Seymour & surrounding areas to grow their confidence, skills & explore personal goals & goal setting.

The heart of our program is to further educate women in their own financial independence through FREE** one on one coaching and supportive workshops.

Consent to collect your Information

We need to collect some information about you as part of registering your interest in the SEED Project.This helps us to get an understanding of your situation and needs.

By completing this Registration Form, I understand that the Brotherhood of St Laurence will use this information to determine my eligibility for the SEED Project and store your details in the BSL information system to be used for the program monitoring and reporting. if at any time you change your mind please let us know.

Your de-identified data may also be used by Brotherhood of St. Laurence for research purposes to ensure that we are able to continually assess and improve the program, and to inform our policy advocacy and program innovation

It will be kept confidential and in accordance with the Brotherhood's privacy policy available herehttps://www.bsl.org.au/privacy-policy/.

Do you give us the consent to BSL to use your information to register your interest in The SEED Project? *

AgreeDo not agree

We need your consent to collect the information and express interest in the SEED Project. If you do not prefer to give us the consent, please click next.

Referral mode *

Self-referral3rd partyInternal

For all 3^rd party referals please ensure that the person being refered has given consent and is aware that they will be contated by SEED.

Please note SEED is not a crisis service please consider this when referring women, please advise the participant that a member of The SEED team will be in contact within 2 business days.

A member of The SEED team will be in contact within 2 business days.

Organization name: *

Contact person name: *

Contact phone number: *

Where did you hear about us? *

Where did you hear about us - Other: *

Please specify the service provider: *

Your personal details:

First Name *

Last Name *

What is your gender identity: *

FemalePrefer to self-describe

Gender Identity - Self describe:

Year of Birth *

Month of Birth *

Day of Birth

Preferred method of contact *

What is your Phone Number?

Post Code *

What is your email? (If you do not have email type N/A) *

Address

What part of the program are you most interested in?

Other - Please specify:

Additional Comments

Closing section

Preferred contact time – you can select multiple options *

9:00 AM - 12:00 AM12:00 M - 3:00 PM 3:00 PM - 5:00 PMAny time