Little Dreamers Australia
Service Providers
Dreamers Hub
About Us
Our Story
Friends of Little Dreamers
Programs
Apply for Support
Get Involved
Donate
Volunteer
Workplace Opportunities
Careers
Updates
Blog
Newsletters
Our Impact
Events
VIC
NSW
QLD
Menu
Donate
Contact
Shop
Little Dreamers
»
Group Mentoring Application
Group Mentoring Application
Young Carer Contact Details
First Name
*
Last Name
*
We’d love to get to know you and put a face to the name so please attach a photo of yourself (and the person you care for if you have one)
*
Gender
*
Age
*
Phone
*
Date of Birth
*
Are you currently engaged in education?
*
Yes
No
If yes, what type of education?
---
Primary School
Secondary School
VCAL
TAFE
SEDA
Name of institution?
Email
*
This will be the email address used for your zoom account and where we will send you the link each week to join the video call.
Address
*
Please make sure this is your postal address as your resource pack will be sent to this address.
Parent or Guardian Contact Details
Name
*
Relationship
*
Email
*
Phone
*
Address
*
About The Caring Role
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
How many people do you care for?
*
---
1
2
3
4
5 or more
Tell us a bit about your role as a Young Carer.
*
Subscribe to updates from Little Dreamers
Back to Top
Menu
About Us
Our Story
Friends of Little Dreamers
Programs
Apply for Support
Get Involved
Donate
Volunteer
Workplace Opportunities
Careers
Updates
Blog
Newsletters
Our Impact
Events
VIC
NSW
QLD
Donate
Contact
Shop
Menu
Search Little Dreamers Australia