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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
*
Male
Female
Other
Phone
*
Email
*
Address
*
Please type in and select through the auto-completion
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ACT
NSW
NT
QLD
SA
VIC
WA
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
*
Back
Next
About your caring role
How many people do you care for?
*
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1
2
3
4
5 or more
What is your relationship to the person/s you care for?(Select all that apply)
*
Brother
Sister
Father
Mother
Grandparent
Guardian
Other
Please select the reason/s why you provide care?(Select all that apply)
*
Physical disability
Intellectual disability
Mental health
Addiction
Chronic illness
Cancer
Autism Spectrum Disorder
Degenerative disorder
Genetic disorder
Acquired Brain Injury
Frailty/old age
Carer of siblings due to parent unavailability
Other
Tell us a bit about your role as a Young Carer.
*
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Next
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 areas you would love some support in?
*
If you could look into the future, what would you be doing in 5 years time?
*
Out of all of the parts of the program, which are you most excited about?
*
Meeting other Young Carers
Having your very own mentor
Career support
Leadership development
Camp/respite
Will you need someone to help at home while you're on camp/at workshops?
*
Yes
No
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?
*
Yes
No
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.
*
Yes
No
I have read and understood the Privacy Collection Notice.
*
Yes
Privacy Collection Notice available at
littledreamersonline.com/privacy-policy
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Menu
About Us
Programs
Dream Experience
Holiday Program
Big Dreamers
Mentoring
Dreamers Hub
The Young Carer Project
Carer Gateway
Apply for Support
Get Involved
Volunteer
Corporate volunteering
Donate
Fundraise
Partner
Work with us
News
Blog
In the Media
Events
Contact
Donate
Shop
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