Register your interest

Thank you for your interest in the Bundaberg Defib Hero Community Activation Program.

Please fill out the details and we'll get back to you with further information.

Council is collecting your personal information (e.g. name, address, phone number etc.) which will be used for the purposes of collecting information for the Bundaberg Defib Hero Community Activation Program. This information will only be accessed by authorised Council officers and Heart180 (Defib Hero Community Program organisers) and handled in accordance with Council's Privacy Statement governed by the Information Privacy Act 2009. Visit bundaberg.qld.gov.au/privacy for more information.

Any questions regarding this survey can be directed to Council's Community Engagement team at engagement@bundaberg.qld.gov.au.

Full name

* required

Maximum 255 characters

0/255

Business/Community Organisation

* required

Maximum 255 characters

0/255

* required

Mobile phone number

* required

Maximum 255 characters

0/255

Physical address

* required

Maximum 255 characters

0/255

Tell us how you would like to be involved (choose all that apply)

* required

I would like to log the location of a defib (AED)

I would like to stay informed regarding the Defib Hero Community Program

I would like to support or participate in the Defib Hero Community Program

Other (please specify)

Please give us any further comments