Youth Services- Program Application Form

1. Personal Details

There are currently vacancies for young people aged 12 to 25 and who live, work, or go to school in Moonee Valley to get involved in Youth Services programs and make a difference in 2012.

All groups are open to young people from across Moonee Valley. No skills or experience needed, just enthusiasm and the willingness to have a go.

Joining a youth program is a great opportunity to make new friends, develop new skills and make a positive change in the community.

To join any of these groups, or find out more information please contact Youth Services on 9243 8888 or email youth@mvcc.vic.gov.au

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* 1. Personal Details

Name: *

Address 1: *

Address 2:

Suburb: *

Date of Birth: *

Home Phone:

Mobile:

Email Address:

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

Home Phone

Mobile

Email

Mail

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* 3. Gender

Male

Female

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* 4. Are you currently:

Attending school

Attending University/TAFE

Employed (Full time)

Employed (Part time)

Unemployed

Please name your School/Uni/TAFE/Employer