Volunteer Mentor EOI Form
The 1:1 Positive Pathways program aims to foster positive life choices and relationships for young people who are involved in, or at risk of involvement in the youth justice system. Please fill out this form if you are interested in volunteering to become a role model for young people.
First Name
*
(Must match your legal documentation for Working with Children Check and Police Check)
Last Name
*
(Must match your legal documentation for Working with Children Check and Police Check)
What are your gender pronouns?
Gender Identity
*
Female
Male
Intersex
Non-binary
Prefer Not To Say
Prefer to self-describe
How do we contact you?
Preferred Phone
*
Mobile
Work
Home
Phone Number
*
Please enter a valid phone number.
Mobile Number
*
Please enter a valid phone number.
Email
*
example@example.com
Your Suburb or Town
*
Preferred 1:1 Program Location
*
Bendigo
Latrobe
Melton
Please tell us why you are applying for this volunteer role, and any relevant skills and experience.
*
How did you hear about us?
*
Please Select
Pamphlet/Postcard
Website
From my employer
Word of mouth (Colleagues, Friends, Family)
Owner ID
Title
Company
Submit
Should be Empty: