Application Form
Young Person's Name
*
Young Person's Date of Birth
*
Parent/Carers Email
*
Parent/Carer Phone Number
*
Church attended
*
School/College Attended (if applicable)
Short Statement from the young person outlining what they feel they would bring to the Youth Forum
Words of Support from their Youth Leader or Parish Priest
The personal information you provide to us will be used by members of Blackburn Diocesan staff to contact you regarding the Youth Forum. We will not share it with any third parties. I understand and agree to my information being used in this way. (required)
YES
Submit
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