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Age Friendly Darebin Participation

Stay involved!
Tell us how you would like to be part of making Age Friendly Darebin happen:
1. How would you like to continue to be part of Age Friendly Darebin? (Choose all that apply) *This question is required.
2. Contacting You *This question is required.
Are you happy for us to contact you to discuss your options and availability? *This question is required.
Please provide your name and phone number:

The collection and handling of personal information is in accordance with Council's Privacy Policy which is displayed on Council's website and available for inspection at, or collection from, Council's Customer Service Centres. The personal information collected from you will only be used for the purpose of this survey and Council will treat your information confidentially.  *This question is required.
Space Cell Details
Full name *This question is required
Phone number *This question is required
2. Your Age Group
2. Your postcode