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* 1. Your given name?

* 2. Your surname?

* 3. How would you like your name to appear on official Youth Parliament documents?

* 4. Your date of birth?

Date / Time

* 5. How old will you be on the 8th of July 2018?

* 6. Your gender?

* 7. Your primary phone contact?

* 8. Is this your personal number?

* 9. A secondary phone contact?

* 10. Is this your personal number?

* 11. Your email address?

* 12. Please confirm your email address.

* 13. Your postal address?

* 14. Your suburb/town/city?

* 15. Your postcode?

* 16. Do you currently...

* 17. If you are studying, what is the name of your institution, and what course are you studying?

* 18. Are there any factors that may impact on our capacity to support your participation in Youth Parliament

* 19. Do you live, or is your permanent home in, a regional, rural or remote area of Western Australia?

* 20. Do you identify as being of Aboriginal or Torres Strait Islander origin?

* 21. What language do you speak at home?

* 22. What is your country of birth?

* 23. Do you identify as having a disability?

* 24. What type of high school do you/did you attend?

* 31. What significant issue facing youth today are you most passionate about and why? (200 word limit)

* 32. Why do you think you should be selected to participate in Youth Parliament 2018? (200 word limit)

* 33. What do you want to achieve through your participation in Youth Parliament 2018? (200 word limit)

* 34. Have you participated in Youth Parliament before?

* 35. Are you currently a member of a Political party?

* 36. Where did you hear about Youth Parliament?

* 38. Have you read and understood the Application Pack?

* 39. Are you able to, if accepted, to commit to attending all Youth Parliament events including Training Day (April 7th) and the Residential Camp (July 8th-13th)?

* 40. Do you accept the Terms and Conditions of the Western Australian YMCA Youth Parliament program, as published on our website?

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