Download the Youth Infusion application form - Hutt City Council

HUTT CITY COUNCIL YOUTHCOUNCILFor more information on Youth Infusion:contact the Youth Council Coordinator mobile on 027 516 4877,email leole.malama@huttcity.govt.nzGoogle “Youth Infusion Hutt City Council”Find Youth Infusion on Facebook “Youth Infusion Hutt City”Hutt City Council Youth Council Application: I WANT TO JOIN YOUTH INFUSIONYouth Infusion wants to engage as many young people as possible and provide opportunities for young people to developthemselves and to contribute to their community. Youth Infusion was established by Hutt City Council as a voice for youngpeople in the decision making of Hutt City. Youth Infusion members respect their role as young leaders and theirrelationship with Hutt City Council. By joining Youth Infusion you can help develop your community by ensuring the voice ofyoung people in Lower Hutt is heard. Please fill out the form below— PRINT or TYPE.Surname:First Names:Address:City/Zip Code:Phone: Home ……………………………… Mobile ……………………………………. Work ………………………………….Email address:Birth date:Age:School:Year:Ethnicity:Occupation:Hobbies/Interests:1) List reasons why you are interested in becoming a member of Youth Infusion?2) What special skills do you think you can bring to the Youth Council?Youth Infusion Application Form1

3) To be an active member of Youth Infusion you should be available to attend at least 2 meetings permonth and support (in some way) all Youth Infusion projects:• I can do this• I am too busy4) Name other groups/clubs you are involved in and how often they meet. e.g. Sports, Church, Cadets5) Tell us about something you have done that you are proud of- this might be something you finished,a challenge you have faced or something you did as part of a group:6) Youth Infusion has an Executive Team of the youth council that ensures Youth Infusion is achieving its goals andcommunicating with the right people. This involves added responsibility and commitment to Youth Infusion. Those whoare not on the executive team are members of the youth council, and can still lead in areas (i.e. run an event), with thehelp and partnership of the executive team and interested members of Youth Infusion. Alongside the Executive team,Youth Infusion also has trainees alongside Executive members so they can be trained up into the roles for whenExecutive members stand down or leave.• Do you want to be an Executive Member?• Do you want to become an Executive trainee to start training to take over an Executive role?• A Team Member?The YOUTH VOICE in Hutt City Council – YOUR VOICE in the CommunityTo become an official member of Youth Infusion you will be required to:• Attend a recruitment night and/or a one-on-one interview with the Youth Council Coordinator• Be an active member of YI for 3 months• Attend at least 7 YI meetings in the 3 month period• Be involved in YI projects and initiativesTo ensure the safety of Youth Infusion members, and ensure that Youth Infusionmembers recognise their responsibility to the Council and community you must:• Get parental consent to join Youth Infusion (if you are under 16)• Agree to have a background check (fill out attached form)• Read and agree to the Youth Infusion Code of ConductYouth Infusion Application Form2

CHECK LIST• Have you looked at the Terms of Reference and Code of Conduct? YES/NO• Do you understand what the purpose and role of the Hutt City Council Youth Council is? YES/NO• Will you be available for meetings at 6pm on Wednesdays? YES/NO• Have you completed the Ministry of Justice form and attached a photo ID? YES/NOPlease sign and date below:Signature ………………………………………………… Date ……………………………By signing you state that all the information is true and agree to the terms and conditions of becoming aYouth Infusion member (as outlined in the Youth Infusion Code of Conduct). You allow your contactinformation to be used by the Youth Council Coordinator and the Youth Infusion Leadership Team, all otherinformation provided by the applicant remains confidential.Please return this application to:Leole MalamaYouth Council CoordinatorCommunity DevelopmentHutt City Council30 Laing's RoadPrivate Bag 31912Lower Hutt 5040Email: youth.infusion@huttcity.govt.nzOFFICE USE ONLYYouth Council Coordinator will contact you to arrange an interview(Sign below once application has been approved)Signature ………………………………………………… Date …………………………….Youth Infusion Application Form3