headspace Box Hill are looking for young people aged 16-25 who want the opportunity to be heard and be active around youth issues. The group is excited to include and hear the voices of a diverse range of young people. As a reference group member, you will play a part in several roles, such as helping to lead and organise a project, having a voice for young people, and a say in youth issues that affect our area, among other responsibilities.

This form will take approximately 15 minutes to complete.

Position Description

You can find the position description on our website:

Join our Youth Reference Group | headspace Box Hill

Please read the position description before applying

Applications close on the 7th August 5pm

Personal Details

First Name *

Last Name *

Preferred Name

Date of Birth *

Best Contact Number *

Email Address *

Current Home Address *

Please describe your study or occupation situation or goals *

What Pronouns do you use?

How do you describe your gender?

Do you have a Working with Children Check (WWCC) *

YesNo

If yes, what is your Working with Children Check (WWCC) number?

If you do not currently hold a WWCC

I am under 18 years of ageI am currently in the process of applying for a WWCC and waiting for it to be approvedI do not have a WWCC, but I am willing to apply for one

Emergency Contact Details

Emergency Contact Name *

Emergency Contact Relationship to You *

Emergency Contact Number *

Emergency Contact Email *

If we are required to contact this person, is there anything we should be aware of? *

Why do you want to join the Youth Reference Group (YRG) at headspace Box Hill? Please provide as much detail as possible and paint a picture as to who you are as a person.

Please tell us a little about yourself *

Do you have any lived or living experience that you would like to share as a part of the YRG?

Please outline why you are interested in becoming a Youth Reference Group (YRG) member? *

What skills/ideas could you bring to the Youth Reference Group (YRG)? *

Are you involved in any other voluntary organisations? If yes, which ones and what is your involvement?

If you have a CV that you would like to upload, do so here:

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Any other information you would like to provide?

Demographic Information & Additional Details

This information is not required; however, it helps us to create a demographic picture for the Whitehorse/Manningham area.

Do you identify as Aboriginal and/or Torres Strait Islander?

Do you require the services of an interpreter?

YesNoUnsure

If yes, what is the language/dialect required?

Do you have any communication or access needs?

Yes NoUnsure

If yes, please describe the nature of your needs.

Do you identify as LGBTQIA+?

YesNoUnsurePrefer not to answer

Availability for YRG Meetings *

Tuesday 4-6pmWednesday 4-6pmThursday 4-6pmI am also available to help out at occasional events and activities that may be at different times

Comments

Position Description

Personal Details

Emergency Contact Details

Why do you want to join the Youth Reference Group (YRG) at headspace Box Hill? Please provide as much detail as possible and paint a picture as to who you are as a person.

Demographic Information & Additional Details

Thank you!