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* 1. Your given name?

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* 2. Your surname?

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

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* 4. Your date of birth?

Date / Time

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

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* 6. Your gender?

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* 7. Your primary phone contact?

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* 8. Is this your personal number?

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* 9. A secondary phone contact?

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* 10. Is this your personal number?

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* 11. Your email address?

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* 12. Please confirm your email address.

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* 13. Your postal address?

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* 14. Your suburb/town/city?

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* 15. Your postcode?

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* 16. Do you currently...

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

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

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

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

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* 21. What language do you speak at home?

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* 22. What is your country of birth?

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* 23. Do you identify as having a disability?

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

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

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

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

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* 34. Have you participated in Youth Parliament before?

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

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* 36. Where did you hear about Youth Parliament?

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

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* 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)?

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* 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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