Expression of Interest

This form is for those expressing interest in participating in the Preventing Gender and Disability Based Violence Credential (the Credential), to be recognised by WDV for their understanding and practice of preventing violence against women and gender diverse people with disabilities. We expect significant interest and hope that you will provide a clear indication of why you would like to be chosen as a credential participant.

WDV collects Personal Information so we can effectively deliver and evaluate our activities as a systemic advocacy service for women and gender diverse people with disabilities. WDV will only collect your Personal Information with your consent. WDV is committed to keeping your Personal Information safe in accordance with Australian Privacy Laws. For more information on how we will use and store the information you provide via this form, download our privacy collection statement.

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1. First Name (Required.)

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2. Surname (Required.)

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3. Pronouns

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4. Organisation (if applicable) (Required.)

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5. Role (if applicable) (Required.)

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6. Which best describes your employment status? (Required.)

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7. Which best describes your sector? (Required.)

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8. Which best describes your position/role? (Required.)

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9. Have you completed at least 3 hours of violence prevention training with Women with Disabilities Victoria? (Required.)

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10. If you answered “No” above, would you be willing to commit to the two-day Professional Development on Preventing Gender and Disability Based Violence on March 3rd and 4th from 10:00 AM to 3:00 PM? Completing this training will make you eligible for The Credential, and you can choose to do both.

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11. If yes, which training did you undertake? (Required.)

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12. If yes, when did you undertake training with WDV? (Required.)

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13. Are you available to attend the initial credential meeting and 2 follow-up meetings at the dates and times below? (Required.)

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14. Will you have capacity to review and reflect on 3 WDV resources?

1x written resource
1x audio/ video/ infographic resource
1x intersectional resource (migrant and refugee/ LGBTIQA+ people with disabilities)

Please note the time commitment depends on the resources you select from each category. A list will be made available. (Required.)

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15. As part of the credential assessment, can you commit to writing a brief proposal and/or delivering a short presentation outlining your action plan to address an identified problem within your practice/ organisation? (Required.)

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16. Why would you like to be considered in undertaking the credential process? (50-100 words) (Required.)

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17. Do you have the support of your Manager to undertake the credential process? (Required.)

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