YOUTH EOI – Level Up Your Future
Complete this form to express your interest in the career event and prepare for an inspiring experience.
Student Full Name
*
First Name
Last Name
Age
*
Mobile Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
*
example@example.com
Home Suburb
*
School Name
Current Year Level or School Leaver
*
Please Select
Year 10
Year 11
Year 12
School Leaver (2025/2026)
Other
Are you a high school student, school leaver, or young adult exploring career options?
*
High school student
School leaver
Young adult exploring career options
Parent/Carer Full Name
First Name
Last Name
Parent/Carer Mobile Number
Please enter a valid phone number.
Format: (000) 000-0000.
Parent/Carer Email Address
example@example.com
Emergency Contact Name
*
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Relationship to Student
*
Cultural Background / Pasifika Identity (optional)
What careers, industries, or study pathways are you interested in?
What would you most like to get out of this event?
Would you like to be considered for the 6-month mentoring program?
Yes
No
Maybe
Are you happy for SCCALA to contact you about this event and future youth opportunities?
*
Yes
No
Dietary Requirements or Allergies
Accessibility or Support Needs
How did you hear about this event?
Please Select
School
Friend/Family
Social media
Community group
Other
Contact SCCALA
For any questions about this form or the event, please get in touch using the details below.
SCCALA Inc (Samoan Community Culture Arts & Language Association)
Email: sccala.inc@gmail.com
Phone: +61 425 292 950
Register Interest
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