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Contact Details Update
- for Youth
Personal Details
*
Indicates required field
First Name
*
Surname
*
DOB (dd/mm/yyyy)
*
Gender
*
Male
Female
Mobile Number
*
Email
*
Preferred Contact Method(s)
*
Phone Call
Text Message
Email
Private Facebook Message
What Social Media do you use?
*
None
Facebook
Twitter
Instagram
Other (please list below)
Other Social Media:
*
Home Details
Primary Address
*
Primary Suburb
*
Primary Postcode
*
Home Phone Number
*
Who's home is this?
*
Parents - both
Mum's
Dad's
Other family member (please list below)
Other (please list below)
Other
*
Postal Address (if different)
*
Postal Suburb
*
Postal Postcode
*
Secondary Address
*
Secondary Suburb
*
Secondary Postcode
*
Phone Number
*
Who's home is this?
*
Parents - both
Mum's
Dad's
Other family (please list)
Other
Untitled
*
Family Details
Do any of your family members attend C3 Wynyard
*
No
Parents - both
Mum
Dad
Siblings
Education Details
What is your current study type/level?
*
Grade 7
Grade 8
Grade 9
Grade 10
Grade 11
Grade 12
Grade 13
Apprentice/Trainee (please list details)
University (please list course)
Other (please list)
No
Other study type/level
*
Educational Institution
*
Wynyard High School
Yolla High School
Burnie High School
Marist Regional College
Hellyer College
UTAS
Skills Institute
TAFE
Other (please list)
Other educational institution
*
Employment Details
Do you currently work?
*
Yes (please list)
No
Where do you work?
*
I give permission for my BASIC details to be shared with church members (i.e. in a public church directory)
*
Yes
No
Birthdays, etc. will not be shared
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