Peer Mentor Registration Form 2025

Name

Date of Birth

Gender

Male
Female

I am applying for the below position (under 18 years requires parent/guardian permission)

Peer Mentor (for students 10 years and older with good selfcontrol and leadership skills)
Camp Leaders (students in Years 11 - 13 with excellent problem solving skills, self-control and leadership qualities)
Camp Counsellors (University/College students pursuing social work, psychology, education or other relevant field of study. Must be able to present a police clearance and child protection training certificate before the start of camp.)
Camp Volunteer (Professionals with police clearance & Child Protection Training wishing to offer support or gain work experience with children)

Current Grade or Level of Education

Brief description of previous work experience with children

Are you available Mon - Fri; 7.30 am - 3.30 pm July 8th - 18 th ?

Yes
No
Below is my availability

Primary Contact Email

Primary Contact Phone Number

Parent name and contact details to confirm application if applicant is under 18 years

I confirm that the contents of this applicaiton is accurate to the best of my ability and confirm that I will attend a Orientation and Training prior to the start of camp. Confirmation of entry into the camp is contingent on completed application, request of proof of work experience, and relevant screenings.

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Peer Mentor Registration Form 2025

Gender

I am applying for the below position (under 18 years requires parent/guardian permission)

Are you available Mon - Fri; 7.30 am - 3.30 pm July 8th - 18 th ?

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