Geelong Youth Leadership Program nomination form

The 2020 Geelong Youth Leadership Program is now open for nominations.


Fields marked with * are required

Program pre-requisites

The Youth leadership program has a small number of pre-requisites which must be met in order to be eligible for the program.

Please tick below to confirm your nominee is able to meet each pre-requisites 







Nominee details
Please enter the details of the person you would like to nominate for the 2020 Geelong Youth Leadership Program.












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About the nominee

In the section below please set out the reasons why you are nominating this young person.

We are dedicated to reflect diversity in our 2020 program so please help us by letting us know if the nominee identifies as being part of a diverse group.











For example:

  • Do you see leadership qualities that are waiting to be celebrated and enhanced?
  • Will it assist with their self esteem? 
  • Will connecting them with people from diverse backgrounds help them develop social conscience? 
  • Will the young person benefit from new positive social connections?


Nominating individual or group details








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