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Little Dreamers » Big Dreamers Application

Big Dreamers Application

About you
About your caring role
About the program

About you

First Name *

Last Name *

Date of birth *

Age *

Gender * MaleFemaleOther

Phone *

Email *

Address * Please type in and select through the auto-completion

State *

Name of School * We'd love to put a face to the name so please upload a current photo of yourself! *

Emergency Contact

First Name *

Last Name *

Email *

Phone *

Relationship *

About your caring role

How many people do you care for? * What is your relationship to the person/s you care for?(Select all that apply) * BrotherSisterFatherMotherGrandparentGuardianOther Please select the reason/s why you provide care?(Select all that apply) * Physical disabilityIntellectual disabilityMental healthAddictionChronic illnessCancerAutism Spectrum DisorderDegenerative disorderGenetic disorderAcquired Brain InjuryFrailty/old ageCarer of siblings due to parent unavailabilityOther Tell us a bit about your role as a Young Carer. *

About the program

Why are you interested in the Big Dreamers Personal Development Program? * What are three things you think you are really good at? * What are three things you would love to get better at? * We know this is a big question, but do you have any ideas about what you would like to study or what field you would like to work in after school? * What is your dream job? * What are your favourite hobbies/activities? * Are there any outdoor activities that you'd love to do on the retreat? * If you could meet anyone in the world, who would it be and why? * Out of all of the parts of the program, which are you most excited about? * Meeting other Young CarersHaving your very own mentorCareer supportLeadership developmentCamp/respite Will you require a paid carer for your family whilst you are away on the retreat? * YesNo

If so, does your family obtain NDIS funding? * YesNo

The program includes monthly workshops ON A SUNDAY IN ST KILDA and two 3 day camps, do you think you can commit to a six month program? * YesNo The program includes monthly workshops and two camps. I give Little Dreamers permission to use the photos and information uploaded in this application in marketing materials and share with potential partners related to this application. * YesNo I have read and understood the Privacy Collection Notice. * Yes Privacy Collection Notice available at littledreamersonline.com/privacy-policy

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Little Dreamers is proud to be building our community across Australia. In doing so we pay our respects to our First Nations people, the Traditional Custodians of the land. We acknowledge the Elders, past, present and emerging. We seek to build respectful relationships with Aboriginal and Torres Strait Islander communities across the country to support Young Carers from these backgrounds.

We embrace, celebrate and uplift members of LGBTIQA+ communities.

Little Dreamers Australia is a registered charity.

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