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Big Dreamers
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Personal Development Program Application
Personal Development Program 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 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 Carers
Having your very own mentor
Career support
Leadership development
Camp/respite
Will you require a paid carer for your family whilst you are away on the retreat?
*
Yes
No
If so, does your family obtain NDIS funding?
*
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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