THANK YOU FOR TAKING THE TIME TO FILL OUT

FINAL INSTRUCTIONS NO 1 THANK YOU FOR
ASSOCIATED MUTUAL INSURANCE COOPERATIVE THANK YOU FOR
1004 E 8TH AVENUE SPOKANE WA 99202 5095353155 THANK

15 DOES PRISON WORK? MAY I BEGIN BY THANKING
2002 REPORT OF THE COLLECTOR INTRODUCTION I THANK THE
2009 DELTA SIDE BUSINESS ASSOCIATION SCHOLARSHIP APPLICATION THANK

Youth Advisory Group

THANK YOU FOR TAKING THE TIME TO FILL OUT



Thank you for taking the time to fill out this application form for headspace Liverpool Youth Reference Group. Our Youth Reference Group is for young people aged between 16 – 26 years. The Liverpool Youth Reference Group is a safe and supportive environment for young people to share ideas and voice their opinion on how best we can provide mental health services to our local community.



Basic Information:


Name:


Address:


Best contact number:


Email Address:


Age:



Are you:


Aboriginal Torres Strait Islander


Both Neither



Country of birth:




Do you speak a language other than English at home?


Yes No


If yes, please specify:



Have you or someone you know had a mental health issue in the past?


Yes No


If yes please specify if comfortable sharing:





Which of the following describes your current circumstances?


School student TAFE student University student


Employed part-time Employed full-time Looking for work


Transitioning from study to employment


If you are studying, please write the name of your school/ TAFE/ university and the name of your course in the box below. If you are working, please write the name of your employer in the box.





Additional questions:


What makes you interested in headspace?





What youth mental health issue(s) are you interested in?




What would you do to improve the mental health of young people in Western Sydney if you could be like a super hero?




What is the main reason why you are interested in joining the headspace Youth Advisory Group?




What qualities or skills would you bring to the group?





What are your hobbies and interests?





Where to send this form:


After you have completed this form, please email it to:


Nadine Costantini

Community Engagement Officer

headspace Liverpool

[email protected] or alternatively give us a call on

8785 3200



What's the next step?


You will receive a thank you email for your interest in joining the youth reference group and then the Community Engagement Officer along with the Chair of the Youth Reference Group will review your application and if successful will arrange a face-to- face interview.



headspace Liverpool Youth Reference Group Application form Page | 3


2009 DONATE LIFE RUNWALK V OLUNTEER SIGNUP SHEET THANK
2010 GRC CONFERENCE SPEAKER EVALUATION THANK YOU FOR PRESENTING
2011 GOVERNANCE RISK AND COMPLIANCE CONFERENCE SPEAKER EVALUATION THANK


Tags: taking the, thank, taking