It’s great that you’re interested in joining the Magnify Mentoring program. To assist us in matching you with an appropriate mentor, please complete the questionnaire below.
If you have any queries, please contact City of Kalgoorlie-Boulder Youth Coordinator on 9021 9600.

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* 1. Name

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* 2. Gender

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* 3. School

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* 4. Year level in 2017

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* 5. Email address

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* 6. Mobile Phone Number

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* 7. Do you identify as

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* 8. Parent / Guardian Contact Name

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* 9. Parent / Guardian Phone Number

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* 10. Parent / Guardian email address

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* 11. Please provide any health or allergy information that may affect you during this program

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* 12. Tell us about your goals

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* 13. What sort of career interests you and why?

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* 14. What would you like to get from this mentoring program?

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* 15. Tell us about the hobbies, interests, sports and groups you are a part of

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