APPLY TO BE A 2019 MELBOURNE KOKODA KID

The Kokoda Challenge Youth Program (KCYP) 2019 Applications

We're excited to have you apply for KCYP in 2019. By completing this survey, your application will be submitted into consideration for our 2019 Youth Program. The next step will be an interview stage, which you will be contacted by our Youth Manager, Dann Hollingshed. For more information, contact dann@kyf.org.au or visit www.kokodachallenge.com/youth-programs/kcyp

The new intake of Kokoda Kids will be announced at the start of April with the program commencing in May 2019. To be eligible to apply, applicants must be 16 before or 18 after the 30th June 2019.

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Are you ready for the experience of a lifetime?

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* 1. First Name

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* 2. Last Name

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* 3. Address

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* 4. Suburb/Town

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* 5. State

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* 6. Postcode

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* 7. Date of Birth

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* 8. Email

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* 9. Home Phone

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* 10. Mobile

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* 11. Which situation best describes you:

In 2019 I will be in grade 10 at school

In 2019 I will be in grade 11 at school

In 2019 I will be in grade 12 at school

I am currently enrolled in TAFE

I do not attend school

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* 12. If you go to school or TAFE, which one?

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* 13. Please tell us a bit about yourself:

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* 14. What do you know about the Kokoda Challenge Youth Program (KCYP)?

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* 15. What do you hope to achieve by participating in the Kokoda Challenge Youth Program?

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* 16. How do you think the Kokoda Challenge Youth Program might influence your future?

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* 17. Who do you feel will support your involvement in the program? (please specify family members, friends, youth worker etc)

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* 18. Can you please tell us about your known or anticipated time commitments in 2019 (work, family, etc)

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* 19. How would you rate your level of fitness?

Very unfit

Somewhat fit

Fit

Very fit

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* 20. Do you have any known medical conditions?

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* 21. Have you had any past injuries/operations?

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* 22. Do you have a current passport for international travel?

Yes

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* 23. Where did you hear about the program?

PARENT/GUARDIAN INFORMATION

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* 24. Parent/Guardian First Name

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* 25. Parent/Guardian Second Name

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* 26. Parent/Guardian Email

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* 27. Parent/Guardian Home Phone

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* 28. Parent/Guardian Mobile