Support Groups Registration Form Posted on Thursday 29 February 2024Thursday 29 February 2024 by Sian Minary-Bland Support Groups Registration Form Your InformationThe information you provide will be sent to DVCS's administrative email and added to our database. For the Beyond group, your details will be shared with our partner organisation, A Gender Agenda for the specific purpose of delivering this group. If you do not have contact information that is safe for us to contact you on, please call our crisis line on 62800 900 speak to them about registering for a group program and you can also talk to them about any safety concerns or support needs you might have. Your Name* Your Email* Is this email safe to make contact with you on? Yes No Your Phone Number* Is this number currently safe for a service to call you on? Yes No Is this number currently safe for you to receive a text on? Yes No Please describe your gender identity in your own words Do you identify as (select all that apply):* Trans Gender Diverse Intersex Non-Binary Male Female None of the above What is your cultural identity?* Australian Aboriginal and/or Torres Strait Islander Culturally and linguistically diverse Another Identity Are you interested in a specific support group (select all that apply): Beyond - a group for people who identify as trans, intersex and gender diverse Moving On - a group for people who identify as women Do you reside in the ACT and surrounding region?* Yes No Not sure