Stages of Empathy - Expression of Interest Form
Thank you for your interest in Stages of Empathy, FREE theatre-based access and inclusion training to make community activities more accessible for people with disabilities in NSW, VIC and the ACT funded by the Department of Social Services. This training is open to all kinds of groups from arts to sports to scouts to the local bridge club or birdwatching collective! 

Please complete this form so we can understand your needs and get in touch with relevant details.
Community Group/Organisation Contact Person Information

*The email address used in this part of the form will be used to communicate information about booking Stages of Empathy

Community Group/Organisation Details
What is the name of your community group or organisation?
What State would your group or organisation like to host a session?
What type of community group or organisation are you?
Other
What specific activities do you provide your community
How many members does your group or organisation provide activities for?
Does your group currently have any accessibility or inclusion initiatives? 
Please provide details of any accessibility or inclusion initiatives. (If you have a Disability Action Plan or other documentation you can send that through as well or or instead of providing details here) 
What are your main reasons for wanting to participate in Stages of Empathy training? 
Please tick all that apply





List any other training outcomes desired
What is your preferred training format. Note we will only be hosting a handful of online sessions and some will be limited to specific organisations. This training is best done in person and we have funding to travel to you!
Do any members of your ogranisation have accessibility needs? 
Please tick all that apply






Other Accessibility Needs
How did you hear about Stages of Empathy? 
Please tick all that apply
If Other, how did you hear about Rebus?
Do you have any other comments or questions? 
You've reached the end! We really appreciate you taking the time to provide us with this information so we can create the best training experience for your organisation.

Once submitted, our team will be in touch with more details about the training and next steps! You can find out more information about
Stages of Empathy here.  

Rebus Theatre Incorporated