Young Innovators Program Application
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Welcome to the Wyndham City Council x Brimbank Council x Equal Ed Young Innovators Program!

This short registration form is split into four main sections: personal information; background & education; aims & goals; and mentor matching.

Each section is designed to make sure that we have the necessary information to register you in the program, get to know you and your motivations,and begin matching you with your mentors! Your personal information will not be used to influence our selection process.

All your responses will be kept private and confidential. For more information please visit our privacy policy at https://www.equaled.org/privacy-policy

If you have any questions or concerns, please don't hesitate to reach out to Liam (liam.cross@equaled.org) or Jeff (jeffrey.lai@equaled.org).

Section 1: Basic Personal Information
Full name *
Email *
Phone number *
Date of Birth *
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Gender *
Preferred pronouns (Optional)
If you speak a language other than English at home, please specify the language. (If none simply put N/A) *
Do you identify as being from Aboriginal or Torres Strait Islander descent? *
What would you identify your culture or ethnicity as? (Optional)
Anything you would like to make us aware of so that we can make the program accessible and inclusive for you?
Are you between the ages of 18-35? *
Do you live, work and or play in the Brimbank or Wyndham LGA's? *
How did you find out about the program? *
Are you applying as part of a group of people planning to work together on a project or initiative
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