Thanks so much for agreeing to take part in this survey being conducted by Jan Logie, Green Party MP and spokesperson on women's issues, social development and the Community and Voluntary Sector.

We plan on using information collected here in the media, but we will not identify any Refuge in association with any particular information, unless we contact you for consent.  Please note that by completing this form you consent to the information within it being used in the media without identifying features.

We hope to build an overall picture of the funding picture in the domestic violence sector, and to highlight any needs for increased funding. We know you're really busy and your help with this is very much appreciated.