Dandy YAC Application Form

headspace Dandenong Youth Advisory Committee (YAC) Application

Are you aged between 18- 25? Please fill in this form if you would like to be considered for a VOLUNTEER position with the headspace Dandenong Youth Advisory Committee (YAC). All information will be kept confidential. If you're not comfortable answering any of the questions please leave that space blank (bearing in mind that we will need certain contact details to talk to you about your application!). If you have any questions while filling out the form contact Lara Gerrand or Niharika Hiremath at headspace Dandenong on 1800 367 968 or Request.Headspace@each.com.au
Personal Details
Full Name

First NameLast Name
Phone Number
E-mail
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Birth Date

DayMonthYear
Gender
What languages do you speak?
Which cultural background/s do you identify with?
Do you or your family identify as being Aboriginal and/or Torres Strait Islander?

Yes, AboriginalYes, Torres Strait IslanderYes, both Aboriginal and Torres Strait IslanderUnsureNo
Do you identify with the LGBTIQA+ community?

YesNoUnsure
Have you or your family ever been homeless?

YesNoUnsure
What experience do your family members have with a mental illness?
What personal experience do you have with mental illness?
Are you comfortable talking about your mental health journey?

YesNoUnsure
About you...
Please tell us a bit about yourself! (How do you spend your time, what do you do for fun? work? school?)
Can you tell us why you are interested in joining the headspace Dandenong YAC?
What skills and ideas could you bring to the YAC. (For example, first aid, school leadership groups, sporting teams etc)
Are you/ have you been involved with any other organisations or groups? Please tell us about them!
Is there any other relevant information you would like to share?
Thank you for your time. When you are happy with your answers please hit the 'submit' button below. Someone will be in touch with you to discuss your application shortly.
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headspace Dandenong Youth Advisory Committee (YAC) Application