Quick Exit

Youth Frontiers is accepting referrals for young women and gender diverse people, aged 10-17, living in the Illawarra region who have been in contact with the child protection or justice systems, or those who would benefit from a supportive adult.

Refer a young person now by completing this form and a Youth Frontiers team member will be in touch.

Youth Frontiers Mentee Referral

Your details

Your name(Required)
Relationship to young person

Details of young person you're referring

Young person's name
DD slash MM slash YYYY
Gender

Address
Indigenous Status

Parent/Caregiver Details

Name
Has the parent/caregiver been informed of the referral to Youth Frontiers?
Is it ok for Youth Frontiers to contact parent/caregiver?

Emergency contact for young person

Name
Hidden
Hidden

Suitability Questions

Risk Assessment

Please tick and if ‘yes’ please provide more information below.
Current problems with alcohol and/or substance misuse
Experience of domestic and family violence
Behavioural issues
Environmental risks for staff
Mental health challenges
Legal situations
Disability support required
Health or medical conditions
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