top of page
Graffiti wallpaper
Youthline Logo

Young Ambassador Application

If you would like to apply to be a Youthline Young Ambassador, please complete the form below and we will be in touch to discuss your application.

Date of Birth
Health Declaration: Do you have, or have had, any medical condition of which we, as a responsible voluntary organisation, would need to be aware?
Yes
No

To be completed by parent/guardian if applicant is under 16.

I am the parent/guardian of the above-named young person and hereby give my permission for my child to submit an application to become a Young Ambassador

bottom of page