OPYC 2026 Application Form

OPYC Application Form
We are currently looking to recruit young people aged 12-25 from the LGBTIQA+SB community, within the Perth Metropolitan area, to join the Our Place Youth Committee.

As a committee member, you will be responsible for co-designing and implementing the Our Place Project; working alongside staff to plan, develop and facilitate community projects and events; participate in trainings and MORE!

To get involved in the Our Place Project, please submit your application form. Successful applicants will be contacted for interviews.

For more information or to discuss your application, please contact TC at tc.archer@headspacemidland.com.au, Erin at erin.duffy@swan.wa.gov.au, or Sarah at sarah.norman-brown@swan.wa.gov.au
Legal Name*

First NameLast Name
Chosen/Preferred Name*
Pronouns*
Date of Birth*

DayMonthYear
Date
Phone Number*
Email*
example@example.com
Suburb of residence*
Where were you born?*
Do you identify as:*

Aboriginal and/or Torres Strait IslanderCulturally and Linguistically DiverseLGBTQIA+SBNeurodiverseDisabledNone of the AboveOther
About You

To help us learn a bit more about you, please share some information about your hobbies, ambitions, passions and interests.
Please tell us a bit about yourself.*
Minimum of 20 words.
Why are you interested in joining the Our Place Youth Committee?*
Minimum of 20 words.
How did you hear about the Our Place Youth Committee?*
Skills and Strengths
What skills, experiences, or perspectives do you bring that you think would benefit the Our Place Youth Committee?*
Have you been involved in any advocacy, volunteer, or leadership roles before? If so, please describe your experience.*
Are there any specific themes, advocacy opportunities, awareness campaigns or community challenges you are particularly passionate about addressing?*
Goals and Vision
What do you hope to gain from being part of the Our Place Youth Committee?*
If you could create a project or campaign to support LGBTQIA+SB youth or community, what would it focus on and why?*
Accessibility
Is there anything we should know that might affect your engagement in the Our Place Youth Committee?
(Example: disability, impairment, injury)
Do you have any accessibility requirements? (If yes, please provide more information)
Do you have any dietary requirements? (If yes, please provide more information)
Do you have any allergies or medical conditions we should be aware of? (If yes, please provide more information)
Commitment and Availability
The Our Place Youth Committee requires attending monthly meetings, events, and occasional workshops and trainings. Are you able to commit to this level of involvement?*
Do you foresee any barriers or challenges to participating fully in the Our Place Youth Committee, and how can we support you?
(Example: reliable transport, access to internet, other commitments)
Emergency Contact Details

Please provide details for at least one emergency contact who is aged 18 or older.
Emergency Contact #1*

First NameLast Name
Relationship to you*
Example: Mother, Father, Guardian, Support Worker
Phone Number*
Email*
example@example.com
Emergency Contact #2

First NameLast Name
Relationship to you
Example: Mother, Father, Guardian, Support Worker
Phone Number
Email
example@example.com
Should be Empty:

OPYC Application Form

About You

Skills and Strengths

Goals and Vision

Accessibility

Commitment and Availability

Emergency Contact Details