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Youth Mentorship Programme
A 4 week programme for 16-18 year olds during the month of July.
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Email
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Your email
Full Name
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Your answer
Age
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Your answer
Gender
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Female
Male
Please tick the dates you are interested in attending:
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Tuesday 2nd July (12 pm - 4 pm)
Thursday 4th July (12 pm - 4 pm)
Tuesday 9th July (12 pm - 4 pm)
Thursday 11th July (12 pm - 4 pm)
Tuesday 16th July (12 pm - 4 pm)
Thursday 18th July (12 pm - 4 pm)
Tuesday 23rd July (12 pm - 4 pm)
Thursday 25th July (12 pm - 4 pm)
ALL
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Parent Contact Number:
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Emergency Contact Number:
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Home Address:
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Is there a disability / allergy / serious condition / that we need to be aware of? Please give FULL details. If NONE then please type NONE :
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DISCLAIMER
Submission of a completed application form does not guarantee a place.
I am attending this programme out of my own free choice
Send me a copy of my responses.
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