Expressing your interest in the Music Mentoring @ BYRC program

Personal information

First name *

Last name *

Date of birth *

E-mail *

Mobile *

What school are you currently enrolled in? *

Do you live/work/go to school within the Canterbury-Bankstown local government area? *

Yes No Unsure

Please note this program is only for those connected to CBCity

Home address *

Street number and name *

City *

State *

Postcode *

Who is your emergency contact?

Emergency contact name *

Emergency contact mobile *

Emergency contact email *

What is your relationship to your emergency contact? *

Parent/guardian Close family relative (e.g. older sibling)Family relative (e.g. grandparent, aunt, uncle, older cousin, etc,)Family friend (e.g neighbour or a member of same community circles like school/sports, etc.)

Please note your emergency contact has to be older than you

Do you have any medical issues we should be aware of? If so, what are they? *Please note this information is only used to tailor the program to each individual's needs

Expressing your interest in the Music Mentoring program

Are you currently enrolled in a music-related study unit at school? *

Yes No Unsure

Have you taken private music lessons before? *

Yes No Unsure

Do you play an instrument? *

YesNo A little bit

Please note, you do not need to play an instrument in order to be considered for the program

What instrument(s) do you play?

Why are you interested in this program? *Please outline your music aspirations, why you think you'd benefit from a 1:1 mentoring program and who your ideal mentor would be

This program prioritises young people from CBCity facing barriers in accessing private music lessons. Do you believe you are part of this priority group? *

Yes NoUnsure

If not part of a priority group, would you be open to paying a small subsidy to take part in the program?

Yes NoUnsure, depends on how much

Please note the subsidy will be around $45 for the whole program

Spots in this program are limited. Please write a detailed response as to why you think you should be considered for the program? *Please feel free to answer openly and honestly

If selected for the program, lessons will be conducted at Belmore Youth Resource Centre after school hours once a week for 10 weeks. Can you commit to this? *

Yes No Maybe, but would need assistance

What kind of assistance would you need?Please note any travel or accessibility concerns and that Council may or not be able to fulfil your request

If selected for this program, do you agree to participate in a studio recording outcome and any potential public perforamnces? *

Yes No Maybe, would need encouragement

Please note that the studio recording is mandatory but public performances are optional

Anything else you'd like to add?

Do you wish to be added to Youth Scoop e-news mailing list? *

Yes NoAlready subscribed

Youth Scoop eNews is a great way to keep up-to-date on the latest youth-related news and events happening in CBCity

Privacy Notice

In submitting this form, you consent to Council:
1. collecting your personal information as contained in the form; and
2. using the information for the purposes outlined in the form and for any other Council function.

Providing your information is voluntary. Should you choose not to provide the information, Council is unable to process your application/request. You may access any of your personal information that Council holds upon request.