YOUTH – Participant Registration Form Participant registration form 1Introduction2Application You can use this form to Join the Swan Hill NOVO Youth Council / FReeZA Committee Who can use this form Persons aged 12-25 who live in the Swan Hill Municipality While completing this form, we will request Your contact details (including your name, address, phone and email) Your date of birth Your interests and current activities Emergency contact (including name and phone) It will take about 5 minutes to complete this form. After you submit this form We will send you an email receipt to confirm we have received your submission What happens with your information? Youth Inc provides opportunities for you to become actively engaged in "real life" project based work within business of community organisations. When you register with us we ask for details so that we can inform you of any projects suited to you and so we can contact you. We will handle any personal information you provide on this form in accordance with the Privacy and Data Protection Act 2014. We record this information on our customer databases and make it available to relevant Council staff in line with our Privacy Statement. You can access your personal information by contacting our Privacy Officer. About youFull name* Date of birth* DD slash MM slash YYYY Phone*Email* Address* Which are you currently doing?*(Select all that apply) High School University Tafe Working Other Other - Please specify* What are you areas of interest?*(Select all that apply) Business Community Service Environment Event Management Fashion Finance Graphic Design Health Hospitality IT / Computers Journalism Legal Services Marketing Multimedia Music Sport Teaching Visual Arts Youth Service Web Design Other Other - Please specify* Emergency contactEmergency contact - Full name* Emergency contact - Phone*DeclarationDeclaration* I declare that the information provided on this form is true and correct *