Liverpool Youth Council Application Form

* All mandatory fields must be completed

Personal Details

Gender

male
female

Name

Address

Phone

Mobile

Date of Birth

Age

Country of Birth

Language(s) Spoken at Home

Aboriginal or Torres Strait Islander

If answered "other" above, please explain

Please indicate what school/ university/ job

Please provide an example where you have worked as part of a team. What was your role and what did you learn from this project. (For example, sporting teams, Clean Up Australia Day, school project or a work environment).

Name of project:

What was your role in the team project?

What did you learn from this project?

Please explain why you are interested to be a youth leader in your local community.

Please share what you believe is the most important issue, and/or opportunity for young people in Liverpool in the next 2 years?

Are there any other skills you can bring to the Liverpool Youth Council team? (e.g. Graphic design, report writing, public speaking, communication skills).

Have you participated in any community or extra- curricular activities? If yes, please specify.

Youth Council meetings are held once per month. Please think about your other commitments such as family, school, sports, work and friends

] Yes, I can meet on a monthly basis
] I am unsure if I can meet on a monthly basis

What times would you prefer to have the meetings on?

6.00pm – 8.00pm
5.30pm – 7.30pm

Please provide a referee for us to contact. (A referee is someone who knows you and can tell us what you have done in relation to these questions.)

Name:

Relation:

Phone: