Multicultural Fathers Cooking Group

Expression of Interest

To join the Multicultural Fathers Cooking Group by Illawarra Multicultural Services Inc (IMS) and NSW Service for the Treatment and Rehabilitation of Torture and Trauma Survivors (STARTTS).

Family Name

Given Names

Date of Birth

dd/mm/yyyy

Date of Arrival in Australia

dd/mm/yyyy

Are you an Australian Citizen?

What is your visa?

What is your country of birth?

Please list all the Languages you speak:

Phone Number:

Phone

Email:

Address:

Do you have any allergies?

Do you have any dietary requirements?

Do you have any disabilities?

How many children do you have?

Why do you want to join this group?

Do you have any questions for us?

Contact April on 0403 410 607 - apriljane.dowling@health.nsw.gov.au

Contact Amro on 0439 627 260 - azoabe@ims.org.au

I give consent to become a client of STARTTS

I give consent to become a client of IMS

I understand that I can withdraw my consent.

I understand that this activity is free:

Send me a copy of my responses

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