Community Conversation Expression of Interest

Tell us about yourself and why you would like to host a Community Conversation in your community.
 
All your details will be kept private, and DPC will only contact you to provide further information about Community Conversations.
 
You must be over 18 years of age to be a Community Conversation host.
How would you like us to communicate with you? Tick all that apply. *
 
We want children and young people to be part of the conversation. If you are hosting a Community Conversation with children and young people, you will need a Working with Children Check.

Collection notice

In accordance with our privacy policy, the Department of Premier and Cabinet (the Department) - on behalf of the Inspectorate - undertakes to treat any personal information provided by you as confidential and in accordance with its obligations under state and federal privacy law, including the Privacy and Data Protection Act 2014 (Vic). Personal information you provide, such as your name and email address, will only be used to contact you in relation to issues directly related to that purpose.

The Department is using the services of FormSite to administer this form. The Department is responsible for ensuring that FormSite adheres to, and handles your personal information in accordance with our privacy policy. The information you provide is sent to FormSite via a secure URL which has 256 bit encryption (the "https" protocol in the address bar of your internet browser demonstrates this) and will be stored in FormSite's servers, which are collocated exclusively in the cloud with Amazon Web Services. More information about this can be found by visiting FormSite's privacy and security pages.