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Download the Youth Infusion application form - Hutt City Council

Download the Youth Infusion application form - Hutt City Council

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CHECK LIST• Have you looked at <strong>the</strong> Terms of Reference and Code of Conduct? YES/NO• Do you understand what <strong>the</strong> purpose and role of <strong>the</strong> <strong>Hutt</strong> <strong>City</strong> <strong>Council</strong> <strong>Youth</strong> <strong>Council</strong> is? YES/NO• Will you be available for meetings at 6pm on Wednesdays? YES/NO• Have you completed <strong>the</strong> Ministry of Justice <strong>form</strong> and attached a photo ID? YES/NOPlease sign and date below:Signature ………………………………………………… Date ……………………………By signing you state that all <strong>the</strong> in<strong>form</strong>ation is true and agree to <strong>the</strong> terms and conditions of becoming a<strong>Youth</strong> <strong>Infusion</strong> member (as outlined in <strong>the</strong> <strong>Youth</strong> <strong>Infusion</strong> Code of Conduct). You allow your contactin<strong>form</strong>ation to be used by <strong>the</strong> <strong>Youth</strong> <strong>Council</strong> Coordinator and <strong>the</strong> <strong>Youth</strong> <strong>Infusion</strong> Leadership Team, all o<strong>the</strong>rin<strong>form</strong>ation provided by <strong>the</strong> applicant remains confidential.Please return this <strong>application</strong> to:Leole Malama<strong>Youth</strong> <strong>Council</strong> CoordinatorCommunity Development<strong>Hutt</strong> <strong>City</strong> <strong>Council</strong>30 Laing's RoadPrivate Bag 31912Lower <strong>Hutt</strong> 5040Email: youth.infusion@huttcity.govt.nzOFFICE USE ONLY<strong>Youth</strong> <strong>Council</strong> Coordinator will contact you to arrange an interview(Sign below once <strong>application</strong> has been approved)Signature ………………………………………………… Date …………………………….<strong>Youth</strong> <strong>Infusion</strong> Application Form3

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