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Expression of interest for the Children and Parenting Support Services

Complete the below form to self-refer into workshops, programs, parenting networks or community activities with Children and Parenting Support Services (CaPSS).

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Expression of Interest in Parenting Programs

If you are in need of assistance, please check out our need help articles first. If you are in need of emergency relief, please contact your local Salvos.

First Name: *

Last name: *

Date of birth: *

Gender: *

Suburb: *

Email Address: *

Confirm Email Address: *

Phone number:

Preferred day and time to be contacted:

Optional Information

Street address:

Indigenous status:

Residency:

Country of birth:

Date of arrival in Australia:

Preferred language:

Interpreter required/preferred:

Do you identify as part of the LGBTIQA+ Community?: Yes No

Disabilities:

Add Family Members

Family member 1

Name:

Date of birth:

Relationship to you:

Aboriginal and/or Torres Strait Islander: Yes No

Disability: Yes No

Program Options

At CaPSS we really want to provide a useful service to people who are parenting, and so we encourage you to answer as many of the below questions as you feel comfortable to do so, in the knowledge that we do not make an 'assessment' or judgement of anyone or their parenting.

Your answers to the questions below will support us to keep in contact in a way that suits you and to provide a service that is relevant to you and your family.

Which programs are you particularly interested in attending:

Would you like to attend (check all that apply): Groups for fathers Groups for mothers Groups for the LGBTIQA+ community Groups for the Aboriginal Community Groups for migrants and refugees Groups for parents and children together Groups for children

Groups in the morning Groups in the afternoon Groups in the evening Groups on Saturdays

What are your top parenting goals?:

How did you hear about CaPSS?:

Would you be interested in individual support for your family: No Yes - for myself and another person who is parenting (eg partner, former partner, other family member, other adult in the home) Yes - for myself only

Would you like to receive the CaPSS Monthly Newsletter or Weekly Resource Guide?: Yes - Both Yes - Just the Monthly Newsletter Yes - Just the Weekly Resource Guide Neither

*Has COVID-19 contributed to you seeking support today? : Yes No

Consent to be contacted for TSA research and evaluation: Yes No

* Required field

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