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 .