Supporting people to find their own solutions to improve well-being

Self Help Queensland Online Registration Form

Current Size: 100%

SECTION 1 | This information will be published in the SHQ Online Directory

1. Group Details
(eg: per year, per meeting, gold coin, etc)
2. Contact Details
(Not advisable if this is a home address.)
3. Group Description
Please briefly describe the purpose of your group.
eg. Anyone, women only, men only, sufferers, carers, interested others, etc.
eg. Statewide, National, Regional Areas, Specific Suburbs, Postcodes, etc.
eg. 24 hours, Monday – Friday, 9 am – 5 pm, Tuesday and Thursday only. Please ring at a reasonable time, etc.
e.g. Phone Support, Email & Online Support, Meetings (weekly, monthly, biannual etc), Internet Chat Room, Newsletter, Information Kits, Fact Sheets, Library, Peer Support, Guest Speakers, Hospital Visits, Seminars, Workshops, Friendship, Social Outings, Court Support, Personal or Other Advocacy, Social Action, etc.
eg. A Family Abuse Support group might include words such as Domestic Violence, Physical Abuse, Sexual Abuse, Emotional Abuse etc. eg. A mitochondrial Disease Support Group might include people affected by Alpers Syndrome, Barth Syndrome, Lactic Acidosis, Luft Disease, Leighs Disease etc.
4. Search Facilities
eg. Grief and loss, suicide, depression, genetic, bereavement, mental health, intersex, chronic illness, diabetes, asthma, Rett Syndrome, Fibromyalgia, Parenting, GLBTI etc
Any other information/stipulations your group particularly wants people to know about before they make contact with you.
5. Authorisation

Please note that you must be authorized to post this information on behalf of the group.

SECTION 2 | Not for Public View (SHQ internal use only)

6. Contact Information

SECTION 3   |  Free Newsletter Subscription)

If there is not enough room on this form please feel free to add a separate page/s or your group’ brochure.

By submitting this form, you accept the Mollom privacy policy.