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Group Mentoring Application

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? * YesNo

If yes, what type of education?

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) * 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 How many people do you care for? * Tell us a bit about your role as a Young Carer. *

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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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