PSB speaker application | Positive Life NSW

The information given on this form will be treated in the STRICTEST CONFIDENCE. After your application is received, the PSB project officer will then arrange for you to come in to talk about the Positive Speakers' Bureau in more detail.

Your details

Your name:

Your age:

Gender:

Male Female Transgender

Postal address:

Home phone:

Work phone:

Mobile:

Email:

Which phone number(s) can we use to contact you to discuss your application?

Positive Life NSW can call me at home Positive Life NSW can call me at work Positive Life NSW can call my mobile

What are the best times to call you?

To protect your privacy, Positive Life NSW will not leave an identifying message if we are unable to reach you directly.

What times/days would you be available for speaking engagements?

Have you had previous experience in public speaking?

yes no

Which of the following HIV/AIDS issues do you feel most able to speak about?

Your personal experience of living with HIV/AIDS Coming out as HIV Positive (to lovers, family, friends, at work) Your experience of health services (finding the right doctor, receiving treatment, etc.) HIV and discrimination Other

Other detail:

Are there any issues you would NOT like to speak about publicly?

Some of the requests for speakers come from specific professions (eg. nursing, law). Do you have any personal/professional and/or training that would make you the best person to talk to these groups?

Are there any groups that you would NOT like to speak to?

Would you be interested in attending a Positive Speakers' Bureau Training Course?

yes no

Do you have any other skills that may be useful to the Positive Speakers' Bureau?

Submitting your application

How we process your application:

Thank you for your interest in becoming part of the Positive Speakers' Bureau. Submitting this form is only the first step in becoming a speaker. After we receive your application, the PSB Project Officer will contact you to discuss your application further.

For any further information regarding the Positive Speakers' Bureau, please do not hesitate to contact the PSB Project Officer (Tue, Wed & Thu) on (02) 9361 6011 or email: psb@positivelife.org.au.

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