2025 of Golden You Leadership MENTOR Enrolment Form

Golden You Leadership Youth Mentor Enrolment Form

2025
Applicant's Details:
Full Name:*

First NameMiddle NameLast Name
Preferred Name:*
Contact Number:*
Email address*
Home Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of Birth:*
Gender*
Gender Pronouns
Are you of Aboriginal or Torres Strait Islander descent?*
Language spoken at home?
Do you have any allergies, chronic illness, or medical conditions? If yes, please describe in detail below.*
Do you have any food allergies, If yes, please describe in detail below.*
Is there anything else important that I need to know? If yes, please write, in detail, below.*
Do you have

WA Drivers LicenceWorking with Childrens Check (required)National Police Clearance (required)Bus LicenceOther
Please list your WWC card number & Police Clearance details*
Choose your Program:*

Goldefields Youth Camp April 14 - 17 2025Goldfields Youth Camp October 6 - 10 2025
Next of Kin Details:
Full Name:*

First NameLast Name
Mobile Number:*
Email Address:*
Home Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Relationship to you:*
Please tell us about yourself....
Please tell us about yourself. This helps me us to get to know you better and make sure we pair the right students to the right mentor.
Do you have any previous experience working with youth? Please list.
What do you believe are your strengths and weaknesses?
At Golden You Leadership, we want to help you achieve your goals as well. Please tell us what your goals are and why are you applying to be a Youth Mentor?
These free Networking events for 2025 have been created for our Youth Mentors to meet and mingle with our sponsors, guest speakers and invited guest, please select which events you will be able to attend, revelant to your chosen camp.

Sponsors Sundowner, Thursday Night, April 17thMentor Moment Dinner, Thursday night, April 24thSponsors Sundowner, October TBCMentor Moments Dinner, October TBC
Golden You Leadership aims to support its Youth Mentors, as much as it's participants, in achieving their own personal goals.

Once your application has been submitted, we will review your application and email you a list of benefits for becoming a Youth Mentor!

Exciting times ahead!
I understand that this position is a voluntary position.*

Yes, I understand.
I am available for the compulsary training session on site, on the Sunday before camp*

Yes, I understand.Please contact me to discuss this as I may not be available.
I understand as part of being a Golden You Leadership, Youth Mentor, I am committing to staying on site for the duration of the camp (4 nights / 4.5 days ), unless prior arrangements have been made with the camp leader.*

Yes, I understand.
I give permission for my photos / images to be used by Golden You Leadership for advertising, newsletters, in promotional videos.*

Yes, I give permission.No, I do not give Permisssion
I understand that there will be policies and rules of Golden You Leadership that as a Youth Mentor I will be required to sign on the training night prior to camp. These policies ensure that everyone on site is safe and well cared for.*

Yes, I understand.
Full Name:*

First NameLast Name
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Golden You Leadership Youth Mentor Enrolment Form

Please tell us about yourself....