CLE Education Session Request Form Twitter Contact name Email Organisation Phone Who is the education session for? (target audience) Group size (estimated number of participants) Group Description Mostly Male Mostly Female All Male All Female Children (Under 12) Young people (12- 25 years) English is a second language Migrant / refugee background Aboriginal / Torres strait Islander Low literacy Rural or remote Older people (over 65 years); People experiencing, or at risk of, domestic violence; Homeless or at risk Prisoners / people in custody People with a disability or mental illness; Single parents. People experiencing alcohol / drug issues Do participants have preferred learning styles? Lecture style Audio-visual Written activities Interactive Roleplay Physical activities Discussion Other If other learning style please state Do participants need an interpreter? YESNO Language Select English Test If yes, who will book the interpreter? NTLAC to book the interpreter Participant will book the interpreter What is the aim of the session? (Please check all boxes relevant to group) Awareness of services Awareness of legal rights Understand specific laws (see topics below) Self-help skills for community members Train community leaders? Train other service providers? Other If other please state Do you want to book one of our set programs? Select Judgement day field trip for school students Settlement orientation for new arrivals Family harmony for CALD communities Domestic Violence orders for offenders What’s the Law Cop This What Age Can I Topic (Note: if you select more than one topic it may require a number of sessions. If so please request more than one session.) General session on legal aid Police rights Youth rights – What age can I Domestic / Family Violence Family Law Child protection Housing Money Centrelink Employment rights Other If other session please state Preferred date and time Date first choice Date 2nd choice Time first choice Time 2nd choice Notes about your date/time choice Location What facilities are available at the venue? Multiple rooms Internet Audio-visual display (projector+laptop+screen or equivalent) Whiteboard Open space for games/exercises N/A Other Other facilities available Any other information you can provide to assist with planning the session?