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* 1. What is your name?

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* 2. What is your gender?

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* 3. What is your age?

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* 4. Nationality/Ethnicity? (as you would describe yourself to your friends)

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* 5. Phone number?

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* 6. Email address?

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* 7. Do you have any special needs or requirements (e.g. dietary, disability, etc.):

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* 8. . I am available to attend all day on both days

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* 9. Please say if you, or your organisation, have been involved with the No Hate Speech Movement Campaign to date and if so describe how

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* 10. Please name the organisation that will support or work with you to run a No Hate Speech community action after the training. (If you aren't involved in an organisation please state this here)

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* 11. Why would you like to attend this event?

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* 12. Do you have any experience or skills in the following: (tick any that are relevant)

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* 13. Have you personally experienced hate speech? If so please state what type/s of hate speech you have experienced?

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* 14. Is there anything else you would like to add in support of your application

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