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About Us
Good Omen Goodeze Charter
GOG Partner Organisations and Supporters
GOG Member Quotes
Testimonials
GOG Conversation Video Series
Get Involved
START HERE
Membership Application Form
GOG Membership Renewal
Volunteer with GOG
Current Donation Requests
Community Threads Project
GoG Stitching for Mindfulness Project (GOGS FM)
NEWS & EVENTS
News
Feedback
Events
Patterns!
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Community Threads EOI
Completion of this form indicates you wish to find out more about participating in the “Community Threads” project and that you give permission for the GOG community liaison officer to contact you about it.
About you
Questions about you so we can tell ACT Health a little about the type of people who were interested in this project.
1. Your first name
*
2. Your age (in years)
*
3. Your gender
*
Female
Male
Non-binary
Other
Prefer not to say
4. Were you born in Australia?
*
Yes
No
4a. If you were NOT born in Australia, which country were you born in?
4b. If you were NOT born in Australia, what year did you arrive in Australia?
5. What language do you normally speak at home?
*
English
Other
5a. What language do you speak at home?
6. Do you identify as:
Aboriginal
Torres Strait Islander
Both Aboriginal AND Torres Strait Islander
Culturally and/or linguistically diverse other than above
None of the above
Your Experience
Questions about your experience with knitting/crocheting so we can work out how much support you might need.
7. How much experience have you had with knitting?
None at all
Only a little
Moderately experienced
Very experienced
8. How much experience have you had with crocheting?
None at all
Only a little
Moderately experienced
Very experienced
9. What do you want to learn?
*
Knitting
Crocheting
Both Knitting and Crocheting
I don't mind which I learn
10. Do you think you might need one-on-one teaching?
*
Yes
No
11. Would you be happy to receive support within a larger group setting while staying COVID safe?
*
Yes
No
11. Would you prefer to learn with someone one-on-one in your own home?
*
Yes
No
Internet Access
Questions about your access to the internet, computers, and mobile phones so we can best support you.
12. Do you have the internet at home?
*
Yes
No
13. Do you have a computer at home you can use?
*
Yes
No
14. Do you have access to a computer at your local library?
*
Yes
No
15. Do you have access to a mobile phone?
*
Yes
No
16. Do you feel comfortable using a computer to access information or different websites?
*
Yes
No
The Project
Questions about how you heard about the project and why you were interested in taking part, so we know for our future activities.
17. How did you hear about this project? (Tick all that apply):
I heard about it from a friend (word of mouth)
I read about it in the newspaper
I saw a poster / brochure in the library
I saw a poster / brochure in a coffee shop
I heard about it on social media
I found out about it on the web
Other
17a. Other, please describe
18. What attracted you to this project? (Tick all that apply):
I was bored and wanted something to do
I was looking for a way to meet people
I was wanting to take up a new hobby
I was looking for something that I would find relaxing
I wanted to do something to take my mind off worries and things (like the coronavirus)
I wanted to “give back” to the community
Other
18a. Other, please describe
Contact Details
Your contact details so we can get in touch with you and deliver your Starter Kit!
Your first name
*
Your last name
*
Address
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Your email address
Your landline phone number
Your mobile phone number
Preferred method of contact?
*
Landline
Mobile Phone - call
Mobile phone - SMS
Email
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