Title: Full legal name (as shown on your photo ID): Age: Gender: Cultural identification: Mobile Number: E-mail address: Residential Address:
Eligibility criteria I confirm that I;
am an Australian citizen or permanent resident.
have lived experience of mental illness (as a consumer or carer), relevant to the focus of the forum, towards eliminating seclusion and restraint in mental health care.
have financial constraints which prevent me from attending the symposium without a bursary.
am aged 18 years or older.
am aged under 18 years but will be accompanied by a parent/guardian (note: any parent/guardian escorting an under 18-year-old delegate will attend at their own expense).
if under 18 years of age, I have my parents/guardian’s permission to apply for this bursary and attend the symposium. Please include a letter of permission from your parent/guardian.
I am applying as a;
In 200 words or less, please explain why you wish to attend the symposium:
In 200 words or less, please explain how you will share your learnings following the symposium: