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Murray Youth for Youth Application Form

About you

Full Name

Age

Date of birth

Gender

Address

Street Address:

City:

State:

Post Code:

Country:

Contact Number

Email Address

Emergency contact 1

Emergency contact 2

Murray Youth for Youth meetings are held on the first Tuesday of each month at 4:30pm – 5:30pm. Would you be able to attend meetings at this time?

YesNo

Tell us about yourself!

Why are you interested in becoming a member of Murray Youth for Youth

Are you currently involved with any other organisations? Please include sporting clubs, theatre groups, after school activities, etc.

Parent/Guardian Permission (if applicant under 18)

Parent/Guardian name

Parent/Guardian contact number

Parent/Guardian email address

Parent/Guardian signature (Upload photo of signature)

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If you have any queries, please contact the Shire of Murray’s Place and Community Officer on 9531 7708. A member of Murray Youth for Youth will be in contact with you within 2 weeks of receiving your application.

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Murray Youth for Youth Application Form

About you

Parent/Guardian Permission (if applicant under 18)

Contact Us

Acknowledgement of Country