Community Participation Program (CPP)

Use this form to seek involvement from community members e.g. to participate in focus groups or workshops or to attend training sessions to share their story and experience.
Requestor Details
Contact Person: Date:
DASSA Unit: Location:
Email: Phone:

Engagement Details

Question Title

* What is the timeframe for the opportunity (when; for how long etc)?

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* Describe the participation / engagement opportunity (attach supporting documentation e.g. project plan, TOR etc if available).

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* Describe the role of the community participant and types of activities they will be participating in.

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* Are there any specific experience requirements e.g. representative of particular community, used a specific service, age group, cultural group etc.

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* Please provide any further information to assist in engaging the community members:

Signed:



Date:
Please return this form by post or email to:

                    Community Partnership Program
            Drug and Alcohol Services South Australia
                   91 Magill Road  Stepney  SA  5069

                         dassacpp@health.sa.gov.au

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