Youth Collective Application Form

🎄 Christmas Closures 🎄

🎄The Shire Administration Building and Capel and Boyanup Libraries will be closed from 12 noon on Tuesday, 24 Dec and reopening at 8.30 am on Thursday, 2 Jan.🎄

Waste Transfer Station Holiday Hours

• Tuesday, 24th December: Closing early at 12:00 PM

• 27th to 31st December: Open as usual

• 25th, 26th Dec and 1st & 2nd January: Closed for the public holidays.

Emails will not be actively monitored and responded to until we return in the New Year.

Emergency work requests will still be received and actioned on a priority basis by contacting our Call Centre on (08) 9727 0222.

Wishing you a happy and safe festive season.

If you require assistance completing this form, contact the Youth Development Officer on 08 9727 0222.

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Participant Details

Name*

Date of Birth*

Locality*

BoyanupCapelDalyellupGelorupPeppermint Grove BeachStrathamOther

Which Youth Collective Location are you wanting to join?*

CapelDalyellup

Pronouns

Parent / Guardian Details

Name*

Contact Number*

Email Address*

Emergency Contact - Enter if different from above

Application Statement

Please explain a time when you took on a leadership role or demonstrated leadership skills? How did you handle the responsibility and what was the outcome?*

What specific skills or talents do you possess that you believe would make you an asset to the Dalyellup Youth Collective?*

How do you envision contributing to your community; Are there any specific projects or initiatives you would like to undertake?*

What issues or challenges do you see affecting youth in your community and why do you think it's important for young people to have a voice in addressing these issues?*

Declaration

My parent / guardian is aware of me applying for this program and is happy to be contacted for further information via phone call and email.*

Yes

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