batyr@uni Booking Form
Woohoo! Thanks for booking a batyr@uni program.
The following information helps us prepare for the program and deliver the content in the safest and most effective way possible.
Please note that your booking is NOT CONFIRMED until this form is submitted. To be completed and submitted within 2 business days.
Organisation:*
Contact Name:*
First Name Last Name
Contact Number:*
Email
example@example.com
Address*
Street Address
Street Address Line 2
City State
Post Code
Type of Program:*
Date of Program:*
Day Month Year
Time of Program Start:*
: Hour Minutes AM/PM Option
Program Duration:*
PLEASE NOTE: 60 minute is the absolute minimum duration to deliver a safe and effective program. By selecting a program duration, you confirm that batyr will have that amount of time available to deliver program content; i.e. students will enter the venue and any announcements will be made prior to the above start time.
Gender of Cohort:*
Coed Boys Girls
Number of Students:*
We run preventitive, educational mental health programs and the following information will ensure that our programs are delivered safely, at the right time in someone's mental health journey and with the most relatable staff. Everything that you share is completely confidential.
Has this cohort been exposed to any acts of suicide or suicide attempts in the last...*
3 Months 6 Months 12 months Over 12 Months
If within last 12 months, please give more information:
Are there any other known mental health concerns associated with this cohort?*
(any more information you think may be important for batyr to know)
What staff will be present at the program?(including an alternative contact)*
(what staff will be present during the program, eg alternative contact, wellbeing staff, psychologist, etc)
Are there any specific topics you would like us to address?*
(eg if the cohort is experiencing study related stress, we can tailor a speaker to talk to that)
Any additional information:
(this may include topics that might be most relevant to the students, or anything else you would like the team to know about the day)
BOOKING AGREEMENT / CONFIRMATION
by submitting this Information, I acknowledge and agree with the following...
Thank you so much for your valuable time!
Should be Empty:

batyr@uni Booking Form

Thank you so much for your valuable time!