Youth Leadership Team application form

This application form must be completed by the parent/guardian of the participant, unless the participant is over 16 years of age, in which case it may be completed by the participant only. Please download and read our conditions of participation.

(use calendar to select DOB)

Press the down arrow key to interact with the calendar and select a date. Press the question mark key to get the keyboard shortcuts for changing dates.

(Please enter your mobile number with no spaces)
(please enter phone number with no spaces)
(include name and telephone number)
(please enter phone number with no spaces)
(please enter phone number with no spaces)
(please enter phone number with no spaces)

Privacy

The personal and health information is being collected to enable us to administer the Youth Leadership program you are enrolling in and to ensure everyone’s safe participation. If you would like to know more about privacy at Glen Eira City Council, including your right to seek access to any information collected on this form, please see our Privacy Policy and Health Records Policy or contact Council’s privacy officer on 9524 3333.