Youth Momentum

Register | Young People

Name:

Gender:
Male
Female

Date of Birth:

eMail:

Telephone:

Country of Current Residence:

Address:

Postcode:

Are you currently:
At secondary (high) school / sixth form college
At university / FE college / training
No longer in education – already working
No longer in education – looking for work
None of above

Name of your school, college, university or place of work (if applicable):

Are you a regular member of a youth group, community project, sports team or other organised activity in your free time?
Yes
No

If yes, please give details [max – 255 characters]

Which of the following are you most interested in?
Arts / music / drama / film
Sports
Science
Environment / green issues
Politics / economics
Business / enterprise / making money
Other / no preference

Have you taken part in any international youth project or exchange?
Yes, once
Yes, more than once
No

If yes, please give details [max – 255 characters]

Which online social networks are you a member of?
Facebook
LinkedIn
MySpace
BEBO

Other:


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