*1.Are you interested in participating in the 2026 NAIDOC Video?(Required.)

Yes

No

*2.What age group are you? (Select multiple if submitting for a family)(Required.)

Elders (55 years +)

Adults (30-54 years)

Young adult (18-30 years)

High school aged (12-18 years)

Primary school aged (8-12 years)

Junior primary school aged (7 years and under)

*3.Please list participant name/s(Required.)

*4.Please provide your best contact number and/or your email address(Required.)

*5.Which type of participant are you?(Required.)

Aboriginal and/or Torres Strait Islander community member

Ally of Aboriginal/Torres Strait Islander communities