Inception Strategies Survey

Name

First Name

Last Name

Mobile Number

Consent - I hereby authorise Inception Strategies and NSW Government to use the information I provide during the survey to help design appropriate Aboriginal communication and engagement. I understand that I will be paid by Inception Strategies for providing this information via my bank account details entered below.

Yes

Your Bank account Name

BSB Number of your Bank Account

Your Bank Account Number

Aboriginal Language Group

Residential Suburb

Where you live

Your Age

NSW government logo - for survey questions 9-11. (Please note survey questions 9-11 are concept only and do not commit NSW government to any course of action, but instead are included for the purposes of identifying Aboriginal community attitudes about NSW government representation of Aboriginal affairs and services. Inception Strategies and NSW government kindly request that you keep this survey information confidential).