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Motiv8 Registration 2026

*PLEASE CHECK YOUR ELIGIBILITY TO PARTICIPATE*
Motiv8 is a program for Year 8 students only.
All participants must live and go to school in the Benalla Local Government Area.
(This includes: Baddaginnie, Chesney Vale, Devenish, Goomalibee, Goorambat, Lurg, Molyullah, Moorngag, Mount Bruno, Swanpool, Tatong and Warrenbayne.)
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Students need to complete this form together with their parent or guardian.
1.First name:(Required.)
2.Last name:(Required.)
3.Do you have a preferred name? If so, please let us know what it is.
4.Phone number:(Required.)
5.Email address:(Required.)
6.Home address:(Required.)
7.Date of birth: day/month/year - eg 01/01/2002(Required.)
8.What school do you go to?(Required.)
9.What is your gender?(Required.)
10.What are your pronouns?
11.Your parent/guardian's contact details:(Required.)
12.Sole parent/guardian?(Required.)
13.Your siblings (name and age):(Required.)
14.Emergency contact (if different from parent/guardian listed above):(Required.)
15.Do you identify as....
Yes
No
Aboriginal
Torres Strait Islander
Culturally or Linguistically Diverse (CALD)
Refugee or Migrant Background
Deaf/Hard of hearing
Visually Impaired
Disabled/Have a disability
LGBTQIA+
Experienced Homelessness
Experienced Mental Ill Health
Experienced and/or living in out-of-home care
Contact with the justice system
Neurodiverse
Special needs
16.Throughout the year, are you available on Tuesday and Wednesday nights?
Term 2 runs on Wednesday night 5pm - 7pm,
Term 3 runs on Tuesday night 5pm - 7pm,
Term 4 runs on Wednesday night 5pm - 7pm(Required.)
17.Are you committed to join us for the whole year?(Required.)
18.Why are you interested in participating in this program?(Required.)
19.What interests you? (sports, hobbies, etc.)
20.Are you a member of any clubs or groups?
21.What do you do in your spare time?
22.Tell us a time where you have had to face a challenge? What did you do to overcome it?
23.What is the most difficult thing about being a teenager?
24.What's the best thing about being a teenager?
25.Do you think you will need special assistance to complete this program?
26.Do you have any questions for us or anything else you would like to let us know about?
Current Progress,
0 of 26 answered