Community Champion Participation Survey

1.What is your postcode?

2.Many local residents play important roles in supporting others, especially during challenging times like floods. You might find yourself in one (or more) of these roles, whether it was planned or just happened along the way. Which of these roles best resonates with you? (tick any that apply)

Carers – Supporting others (e.g., school principal, childcare manager, NDIS provider)

Sharers – Community information sharers (e.g., post office owner, community Facebook admin, local business owner)

Responders – Provide support during or after events (e.g., SES leader, mud army volunteer, boat owner)

Mentors – Provide advice or advocacy (e.g., community or religious leaders, representatives of diverse groups)

Connectors – Community figures central to community life (e.g., sporting club leaders, P&C members)

Other (please specify)

3.Please provide a brief description of your role during previous flood events.

4.Are you comfortable participating in a short 30 minute phone call to share your flood-related experiences and ideas?(Required.)

Yes

No – Thank you for completing this survey and considering this opportunity to support our community.

5.If we need to follow up, do you have a preference for attending workshops online or in-person (potentially in January)?

Online only (Zoom or Teams)

In-person only

Either online or in-person is fine

Other (please specify)

6.Would you like to contribute anonymously or consent to the use of your identity in the project?

I would like to contribute anonymously.

I consent to the use of my identity in the project.

7.Thank you for agreeing to participate – please provide your contact details below. A team member from Queensland Reconstruction Authority will reach out soon to arrange a time to connect.

Name:

Phone Number:

Email Address:

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