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PSCB Coast & Company - Central Coast Social Peer Group Expression of Interest

Yes. You’re ready to join Coast & Company!
Thank you for your interest in joining Coast & Company, our social peer group in the Central Coast for people with physical disabilities, parents and carers.

Please note: the initial location of the Central Coast-based peer group events will be determined by what is most convenient and accessible to the majority of the group members. Future venues and activities will be planned by the facilitators and the core group members.
Whether you have always lived with physical disability, or have recently acquired disability, or are a parent/carer of a person with physical disabilities, Coast & Company creates breathing space, where you can simply relax, be yourself and enjoy good company with others who truly understand your journey.
About YOU

The following questions will help us understand more about who you are, what you're hoping to gain from our group and how you might contribute to our collective growth. We are very much looking forward to getting to know you!

Note: PDCN greatly values your privacy. The information you provide here will be kept confidential and used to help us select the peer group members for Coast & Company, as spaces are limited.

For more information, our Privacy Policy is available on our website; https://www.pdcnsw.org.au/privacy-policy/

Let’s get started!
Contact Information
1.First Name:(Required.)
2.Last Name:(Required.)
3.Phone Number:(Required.)
4.Email Address:(Required.)
5.Confirm email Address:(Required.)
6.Suburb:(Required.)
7.Postcode:(Required.)
8.Gender:(Required.)
9.Age Group:(Required.)
10.I identify as:(Required.)
11.I have Physical Disability(Required.)
12.I have non-physical disabilities(Required.)
13.To get around the Central Coast, I: (answer all that are relevant to you)(Required.)
14.Which days/times would work best for you to attend monthly meetings? (Select all that apply)(Required.)
15.Coast & Company will grow stronger with regular participation. We’d love to know your capacity to attend monthly meetings:(Required.)
16.Preferred contact method:(Required.)
17.I get to socialise in person:(Required.)
18.I am happy with the amount of socialising I have in my life:(Required.)
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