PANDA Community Champions Application
Thank you for your interest in becoming a PANDA Community Champion. All Community Champions must have had a personal experience of, or supported a partner or family member experiencing perinatal anxiety and depression or postpartum psychosis. Please note that in completing this form you are not giving permission for your details or story to be shared or used in any manner. The information you provide will be used for recruitment purposes only.
Address Line 1
Are you a current PANDA Volunteer?
Are you a parent?
If yes what age/s are your children?
Do you have any personal or professional skills you would like to share as a PANDA Community Champion?
What is your motivation for becoming a PANDA Community Champion?
How did you hear about PANDA's Community Champions Program?
Current Community Champion
Other *(please describe)
PANDA Social Media
* (please describe)
How has perinatal anxiety & depression effected you?
I experienced anxiety during pregnancy
I experienced depression during pregnancy
I experienced anxiety post birth
I experienced depression post birth
I experienced postnatal psychosis
I supported my partner who experienced perinatal anxiety and/or depression
I supported a family member who experienced perinatal anxiety and/or depression
I supported my friend who experienced perinatal anxiety and/or depression
(Please tick - you can tick more than one)
Have you contacted PANDA’s National Helpline for support
When was your most recent experience of perinatal anxiety and/or depression?
0 - 6 months ago
6 - 12 months ago
1 - 2 years ago
2 + years ago
Please tell us about your perinatal anxiety and depression experience/s (ie symptoms, personal impact, treatment & support, recovery)
Max 750 characters
Community Champion Activities
Which Community Champion activities are you interested in?
Sharing your Story
Sharing your story of perinatal anxiety/depression on PANDA’s website
Sharing your story of perinatal anxiety/depression through online and traditional media
Sharing your story of perinatal anxiety/depression via PANDA’s social media posts
Initiating local media activity (eg local papers, talkback radio)
Sharing PANDA social media messages
Running local awareness raising activities
Representing perinatal anxiety and depression and PANDA to local community groups, organisations and government
Providing a consumer voice within the community and perinatal health sector
Promoting PANDA ‘campaigns’
Distributing PANDA resources to local community services and organistions
Keeping PANDA informed of relevant local activities, issues and perinatal support services
Hosting fundraising activities (eg. Lunch Out Loud)
Promoting PANDA fundraising campaigns
Individual fundraising activities (eg marathon, walkathon, pram walks)
Reading, Writing and Research
Providing comment and input about new PANDA resources and projects
Participating in perinatal mental health research projects
Writing pieces for our website or social media posts
Proof–reading PANDA resources /papers
Other ideas you may have for Community Champion activities
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