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Lithgow Community Strategic Plan: Community workshop registration form
You are invited to attend a community workshop to help inform the Lithgow Community Strategic Plan.
Please complete this form to register for one of the following workshops:
Saturday 16 May 2026, 10am - 12pm in Hartley
Saturday 16 May 2026, 3pm - 5pm in Wallerawang
Sunday 17 May 2026, 10am - 12pm in Glen Davis
Sunday 17 Mayh 2026, 3pm - 5pm in Portland
*
1.
Which workshop would you like to attend?
(Required.)
Saturday 16 May 2026, 10am - 12pm in Hartley
Saturday 16 May 2026, 3pm - 5pm in Wallerawang
Sunday 17 May 2026, 10am - 12pm in Capertee
Sunday 17 May 2026, 3pm - 5pm in Portland
*
2.
What is your full name?
(Required.)
*
3.
What is your email address?
(Required.)
4.
What is your contact number?
*
5.
Are you a member of a local community group?
(Required.)
Yes
No
6.
If so, which group/s are you a member of?
*
7.
What is your gender?
(Required.)
Male
Female
Non-binary
Other (please specify)
*
8.
What is your age?
(Required.)
17 and under
18 - 24
25 - 34
35 - 49
50 - 59
60 - 69
70 - 84
85 and over
*
9.
Are you a First Nations person?
(Required.)
Yes
No
Prefer not to say
*
10.
Do you speak a language other than English at home?
(Required.)
Yes
No
11.
If so, please specify:
*
12.
Do you identify as a person with disability?
(Required.)
Yes
No
*
13.
Do you require any support requirements to participate in the workshop?
(Required.)
No
Yes (please describe)
