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What community group are you putting forward?
Name
Suburb
State
Australian Capital Territory
New South Wales
Northern Territory
Queensland
South Australia
Tasmania
Victoria
Western Australia
Other
Which MHFA course are you interested in?
Youth
Adult
How many people are you expecting to do the course?
Tell us in 100 words or less why your community would like to take up this opportunity
When would you like to hold the course?
First Preference
Second Preference
Your contact details
Name
First Name
Last Name
Email
