ACT Youth Parliament Application
Full Name
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First Name
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Phone Number
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Date of Birth
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Address
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Afghanistan
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Gender
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Federal Electorate
*
Please Select
Canberra
Eden-Monaro
Fraser
Gilmore
Gippsland
Hume
Indi
Riverina
Unsure
State/Territory Electorate
*
Please Select
Albury
Bega
Benambra
Brindabella
Burinjuck
Ginninderra
Gippsland East
Goulburn
Molonglo
Monaro
South Coast
Wagga Wagga
Unsure
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Why do you wish to participate in Youth Parliament?
What makes you a suitable candidate to represent the youth of your electorate?
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ACT Youth Parliament Application
What drives and inspires you?
What issues are of particular interest to you and why?
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ACT Youth Parliament Application
Preferred Party
Government
Opposition
Third Party
Preferred Committee - please select three
Arts
Education and Training
Electoral Affairs
Environment, Climate Change, and Water
Finance, Commerce, Employment and Workplace Relations
Foreign Affairs, Defence, and Trade
Health and Ageing
Infrastructure and Communications
Law Reform, Policing, and the Judiciary
Minerals and Energy
Population and Migration
Rural and regional affairs, Agriculture and Natural Disasters
Science, Industry, and Innovation
Youth Affairs
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ACT Youth Parliament Application
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