Workplace Registration Form

By joining the Achievement Program, you're demonstrating your commitment to the health and wellbeing of your whole organisation.

Simply fill out and submit this form, and we'll send you your portal log-in details via email.

Fields marked with * are required fields.

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If you are experiencing difficulties in completing this form please contact P: 1300 721 682.

About Your Organisation (Victorian Participation Only)

About your organisation (Victorian participation only)

Organisation Details

I am registering for
Size of organisation / site(s) you are registering for
Contact Details

Contact Details

Main Contact

Second Contact

Achievement Program Membership Agreement

As a member of the Achievement Program, we are committed to becoming a healthy workplace and will work towards meeting the statewide benchmarks for health and wellbeing.

Privacy Statement:

Cancer Council Victoria manages the Achievement Program on behalf of the Victorian Government Department of Health and Human Services and may share the information you provide, including identifying information, with the Department of Health and Human Services.

Cancer Council Victoria and the Department of Health and Human Services will take all reasonable steps to protect the confidentiality of the information you provide while participating in the Achievement Program.

In signing up to the Achievement Program you are consenting to identifying information about your organisation (school, early childhood education and care service or workplace) being shared with health professionals and other participating organisations for the purpose of providing support to your organisation while participating in the Achievement Program.

Further, you are consenting to de-identified information about your organisation being shared with other parties for the purpose of reporting, evaluation or research. However, only combined and grouped data relating to the Achievement Program will be published or presented in the public domain, and no data which could identify, or be reasonably used to identify, a school or individual will be published or presented.

View further information on privacy here.

If you wish to access or change any of the information you have supplied, please phone us on 1300 721 682.