Request SHINE SA For Your Event Form

Please complete the booking form below if you’d like to request SHINE SA to attend an event.

Someone from the SHINE SA team will be in touch with you within five business days of submitting this form.

What is your organisation/group?
Name of contact person*
First Last
Email address*
Enter Email Confirm Email
Phone number*
Please provide your mobile number to be contacted regarding this request
What would you like to request SHINE SA for? (Please note that some of these services may incur a cost)
- Stall/Expo/Conference
- Guest Speaker/Panel member/representative for a day of significance
- SHINE SA service talk (information session)
- Other
What is your event and what is the focus area? (e.g. a pride event, family fun day, student wellbeing day, Wear It Purple Day etc.)
What is the proposed date? (If you're not sure, you can leave it blank)
MM slash DD slash YYYY
What is the location of the event?
Street Address Address Line 2 City State Post Code
Will there be a cost involved for SHINE SA?
- Yes
- No
If you answered Yes, please tell us what the cost is
Who is your event for? (e.g. health professionals, educators/teachers, community, LGBTIQA+ young people, students etc.)
Please provide any other details
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