Equity Access Ticket

First Name *

Last Name *

Email *

Mobile Number *

Location (City or town where you live or work) *

Which traditional lands/First Nations Country do you live?

Your Organisation's Name

Your Role/Position Title

Briefly describe your role and focus in your work or community: *

Why do you want to attend the 2025 Equity Summit? (What do you hope to learn, explore, or connect with?) (150 words) *

How do you plan to use what you gain from the Summit to advance equity in your work or community? (150 words) *

What lived experience or perspective do you bring that you think is commonly underrepresented in equity conversations? (This could relate to your background, community, location, or life experience.) (150 words) *

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I understand that all collected information is handled in accordance with the Australian Privacy Act and Country to Coast Queensland’s (CCQ) Privacy Policy. For further information about how personal information is collected, stored, please see the CCQ Privacy Statement.