Expression of interest in joining the Jigsaw Dublin 15 Youth Advisory Panel

Thank you for your interest in getting involved with Jigsaw Dublin 15. Membership of the Jigsaw YAP is just one of many ways to get involved. The Youth Advisory Panel (YAP) is a group of 12-20 young people aged between 16 and 25 who advise and guide Jigsaw in all areas of their work, from assisting in staff recruitment to sitting on the Jigsaw Management/Advisory Group. Jigsaw also benefits greatly from Young People who raise funds and awareness in communities and who support our message through social media.

This isn’t an exam, so don’t worry about spelling or anything like that. Just tell us in your own words why you are interested in getting involved with the Jigsaw YAP. Don’t worry about long or short answers – we want to know what you have to say. If you need more space just write on the back of the sheet, it’s grand. We can also go through the form together over the phone if you would prefer.

Name: / Date of Birth:
Address: / Gender:
Phone: / Email:
How do you describe your Ethnic / Cultural / National Identity?
(Give your answer as you would to your friends when you are describing the group(s) to which you feel you belong to and most identify with. Answers that others have given include Irish, Irish Traveller, British, British-Irish, Brazilian, Irish-Brazilian, Polish, Polish-Irish, Nigerian, Nigerian-Irish, Indian, Indian-Irish, Lithuanian, Latvian, Chinese, Filipino, Roma etc – the list is endless)
______

1.How and when would you like to be contacted? ______

2.What is your availability if you were to join the YAP? ______

______

3.What interests you about the YAP & promoting positive youth mental health?

4.What do you think might be involved in being part of the YAP?

5.What interests, hobbies and skills would you like to bring to the YAP?

6.What do you hope to gain from being part of the YAP?

7.Are you involved with any other organisations e.g. Foróige, Youthreach or others?

If yes, which one(s) and what is your involvement?

8.Is there anything else you’d like us to know?

Consent (if under 18, to be completed by parent/guardian)

I give my permission to my son/daughter/young person to attend a meeting with Jigsaw staff to explore joining the Youth Advisory Panel. Please note that sensitive topics relating to mental health may be discussed at the initial meeting and as part of the work of the YAP.

Please feel free to contact us to discuss or for further information.

I give my permission to my son/daughter/young person to undergo a Garda Vetting check.

Signed by Parent/Guardian: ______

Print Name: ______

Relationship: ______

Date: ______

Consent – Section 2 (to be completed by young person 18 and over)

I understand that Garda Vetting checks area a legal requirement for joining the Youth Advisory Panel and agree to engage in the process. I understand that a Garda Vetting Disclosure may affect my chance of being offered a place on the Youth Advisory Panel.

Young Person Signature: ______Date: ______

Please return this completed form to Aoife Clerkin, Youth and Community Engagement Worker, Jigsaw Dublin 15, 2nd Floor Blanchardstown Library, Blanchardstown Shopping Centre, Dublin 15. If you have any questions please email or call 01 890 5810.