Aġenzija Żgħażagħ Annex to Casa Leoni

St. Joseph High Road

St. Venera

SVR 1012, Malta

( +356 2388 6139

Registration Form

Name of Organisation:
Address of organisation or meeting place:
Ownership status of the meeting place:
§  / Owned by the group:
§  / Leased by the group:
§  / Rented by the group:
§  / Paid by the hour:
§  / Others (kindly provide details) :
Details of contact person:
§  / Name:
§  / Address:
§  / Tel No:
§  / E-mail:
§  / Position within the organisation:

Please provide a brief description of the organisation including the nature and the aim of the organisation:

Kindly provide a brief description of the structure of the organisation (e.g.: does the organisation have committee/management/organising team etc.)

If the organisation has a committee/managing/organising team kindly provide contact details:

§  / Name:
§  / Address:
§  / Tel No:
§  / E-mail:
§  / Position within the organisation:
§  / Name:
§  / Address:
§  / Tel No:
§  / E-mail:
§  / Position within the organisation:
§  / Name:
§  / Address:
§  / Tel No:
§  / E-mail:
§  / Position within the organisation:
§  / Name:
§  / Address:
§  / Tel No:
§  / E-mail:
§  / Position within the organisation:
When was your organisation formed?
Kindly indicate month during which AGM is held (or when change in committee members is usually effected).
Is your organisation registered as a Voluntary Organisation with the National Commission for Voluntary Organisations? /
Yes / No
If your answer is yes kindly give VO registration number:
Is your organisation affiliated to any other organisation? / Yes / No / Is your organisation affiliated to any other organisation? / Yes / No
(both national or international) / (both national or international)
If your answer is yes kindly give name of organisations:

Does the organisation have any kind of policy regarding membership?

Details of group leaders if any:

Male / Female
Under 18
Between 18-25
Over 25 years of age
Total Members

Details of members:

Male / Female
10-14 years
15-19 years
20-24 years
25 years and over
Total Members

Kindly tick the activities and/or projects your group is involved in:

Arts and Culture / Environmental
Dance/Music / Citizenship/Social Action
Drama/Theatre / Community Development
Politics / Faith Development
Outdoor Education- / Sports
Youth Exchanges / Social and Personal Development

If there are other group activities which are not listed above kindly provide details:

Are the young people involved in the management of the group? / Yes / No
Does the organisation/group have a statute? / Yes / No
Is there a recruitment and selection process for the leaders? / Yes / No
Does the organisation/group provide formal leadership training? / Yes / No

I certify that the information given in this application form for registration with Aġenzija Żgħażagħ is true and correct.

Name: ______Surname:______

Signature: ______Date:______

Terms and Conditions

Personal information provided on this form is protected and used in accordance with the Data Protection Act.

We will not disclose any personal information submitted and will not forward any personal contacts to third parties.

Information submitted and personal contact details can be used by Aġenzija Żgħażagħ to distribute information in relation to opportunities and activities for young people.

For Office use only:
Registration No: / Date:
Comments: / Name & Signature of Youth Officer