To connect with us for support, simply fill in the Support Request Form below to help us understand what you need, or call us 9294 5704 during office hours (Mon-Fri, 8.30am-5.00pm).
All information collected in the Support Request Form will be for Maroondah City Council use only.
Support Request Form
- If you are a young person, please complete Section 1 only and Submit (you can skip Section 2)
- If you are a parent/carer or a worker requesting support for a young person, please complete Section 2 only and Submit (you can skip Section 1)
Do you live, work, study, or play in Maroondah? (select one)
What do you need support with?
You can select one or more options
If you are requesting support of behalf of a young person, please complete Section 2 only and Submit (skip Section 1)
Does the young person live, work, study or play in Maroondah? (select one)
Please note that we will contact you before we attempt contact with the young person.
PRIVACY COLLECTION NOTICE
Maroondah City Council is committed to protecting your privacy as prescribed by the Privacy & Data Protection Act 2014 and the Health Records Act 2001. The information you provide on this form is being collected by Maroondah City Council for the strict purpose of conducting Council business. Your information will not be disclosed to any external party without your consent, unless Council is required or authorised to do so by law.
Failure to provide the information requested may make you ineligible to receive the service or be part of an event/function that is the subject of this form. Any access to the information, amendments that may be required or any privacy enquiries may be directed to Council's Privacy Officer & Health Records Officer on 9298 4211 or email - email@example.com
Our team works Mon-Fri, 8.30am - 5.00pm (excluding public holidays). We will do our best to get in contact with you within 2 business days of receiving your form.
If you have any questions or any difficulty completing this form, please contact Youth Services on 9294 5704. Thank you!