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Greater Bunbury Region Youth Leadership Summit 2026 - Homeschool Student Expression of Interest

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Participant Information
Tell Us About Yourself
Parent/Guardian Declaration
Submit Response

Participant Information

Young Person's Full Name

Date of Birth

Residential Suburb/Town

Street Address:

* Required Field

City:

* Required Field

State:

* Required Field

Post Code:

* Required Field

Country:

* Required Field

Parent/Guardian Name

Parent/Guardian Contact Number

* Required Field

Parent/Guardian Email Address*This field is required.

* Required Field.* Required Field

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Tell Us About Yourself

What are your future career aspirations?

What do you think defines a good leader?

Tell us about something you are passionate about.

Have you been involved in any of the following? (Select all that apply)

Volunteering
Community groups
Sporting clubs
Arts or creative activities
Environmental projects
Youth programs
Faith-based groups
Advocacy or social causes
Other (please specify)

(please specify)

Do you have access to transport to and from the venue on Monday 7th September from 8.30am to 2.30pm?

YesNo

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Parent/Guardian Declaration

Parent/Guardian Consent

I confirm that I am the parent/guardian of the young person named in this application
I understand that submission of this Expression of Interest does not guarantee a place at the Summit
I understand that if the application is successful, further registration and consent information may be required
I consent to the Shire of Capel and Greater Bunbury Region Youth Development Network contacting me regarding this application

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Validate and Submit Form

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Acknowledgement Of Country

We wish to acknowledge the traditional custodians of the land we are meeting on, the Wadandi people. We wish to acknowledge and respect their continuing connection to the land, waters and community. We pay our respects to all members of the Aboriginal communities and their culture; and to Elders past and present, their descendants who are with us today, and those who will follow in their footsteps.

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PO Box 369, Capel WA 6271
info@capel.wa.gov.au
(08) 9727 0222

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