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East Gippsland Shire Council
2020 Youth Ambassadors Application
2.
Your Personal Details
Please ensure all of the details provided are correct
*
1.
What is your name?
(Required.)
First
Last
Preferred
*
2.
How old are you?
(Required.)
*
3.
Preferred Pronouns?
(Required.)
She/Her/Hers
He/Him/His
Them/They
Ze/Hir
Prefer not to say
*
4.
Contact Details
(Required.)
Address
City/Town
State
Post Code
Country
Email Address
Mobile Number
*
5.
Do you identify as Aboriginal or Torres Straight Islander?
(Required.)
Yes
No
Prefer not to say
67%
