Moonee Valley Youth Summit 2012 Registration

Register for the Moonee Valley Youth Summit!

The 2012 Moonee Valley Youth Summit is an event that aims to bring together the young people of our community to discuss issues affecting us and fight for change.

The Youth Summit is organised by a group of passionate young people committed to making Moonee Valley a better place.

All young people inspired to make a difference are invited to join us at the Youth Summit on Friday 20 April, at the Clocktower Centre in Moonee Ponds. The event will run between 9am and 3pm.

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* 1. Your details

Name:

Address 1:

Address 2:

City/Town:

State/Province:

ZIP/Postal Code:

Country:

Email Address:

Phone Number:

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* 2. What is your age?

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* 3. What is your gender?

Male

Female

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* 4. What is the best way to contact you?

Home Phone

Mobile

Mail

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* 5. Are you currently:

Attending school

Attending University/TAFE

Employed (Full time)

Employed (Part time)

Unemployed

Please name your School/Uni/TAFE/Employer

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* 1. Your details

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* 2. What is your age?

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* 3. What is your gender?

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* 4. What is the best way to contact you?

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* 5. Are you currently:

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* 6. Do you any food or dietary issues that we need to know about it?