Volunteer Registration Form

This form is to register your interest as a Volunteer with Breakaway Youth under one or more of the volunteer roles. This form is to register interest only and is not an official application. Please note that Breakaway Staff may take some time to respond as we have many things on, but we will work on it as soon as possible. 

Personal Details
Date of birth
Gender at birth
Referee #1
Full name
Mobile/Phone
Relationship to you
Referee #2
Full name
Mobile/Phone
Relationship to you
Volunteer Roles
Do you have any of the following?




Tell us about yourself
What do you currently do in your spare time?
What experience do you have working with children and young people?
Why would you like to volunteer with Breakaway Youth?
Are you currently volunteering anywhere else?
How did you hear about us?
Breakaway Youth does not tolerate child abuse or discrimination of any kind. Any breaches of the law or our Code of Conduct will be reported.