Canvas3 and BSPHN CALD Community Engagement

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* 1. What is your age?

Under 18

18-24

25-34

35-44

45-54

55-64

65+

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* 2. How do you identify?

Male

Female

Non-binary

Prefer not to say

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* 3. Please select your heritage.

Chinese

Vietnamese

Korean

Taiwanese

Indian

Other (please specify)

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* 4. Your contact details.

Name

Suburb

Email Address

Phone Number

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* 5. What is your preferred way of contact?

By email

By phone

By text

No preference