YSD Expression of Interest Form
(Youth for Sustainable Development)
Fill in all questions to register your interest for the YSD Programme.
ECO-UNESCO’s Youth for Sustainable Development programme promotes Education for Sustainable Development (ESD) in the non-formal education sector through a Peer Education approach.
We’ll equip you with knowledge and skills to bring about sustainable changes in your life and in your community.
Your Details
First Name
Surname
Age
Gender
Please select...
Male
Female
Non-binary
Trans-masc
Trans-fem
Other
Email Address
Mobile number
Where do you live?
Please select...
Carlow
Cavan
Clare
Cork
Donegal
Dublin
Galway
Kerry
Kildare
Kilkenny
Laois
Leitrim
Limerick
Longford
Louth
Mayo
Meath
Monaghan
Offaly
Roscommon
Sligo
Tipperary
Waterford
Westmeath
Wexford
Wicklow
Which club are you looking to join?
Please select...
Dublin
Maynooth
Drogheda
Galway
Cork
Dundalk
If you have selected the
Dublin Club
, what times would suit you best? (select as many as you like)
Tuesday 5pm to 7pm
Wednesday 2pm to 4pm
Thursday 5pm to 7pm
Which school do you go to?
Year in School?
Please select...
Junior Infants
Senior Infants
1st class
2nd class
3rd class
4th class
5th class
6th class
1st year
2nd year
3rd year
4th year
5th year
6th year
What is your motivation for getting involved in the YSD Programme?
Please share additional details that would be useful to know i.e. any special needs/requirements or medical information.
Please outline the supports you require below.
Your Parent/Guardian's Details
Parent/Guardian First Name
Parent/Guardian Last Name
Parent/Guardian Email
Emergency Contact
Emergency contact Name
Emergency contact Phone number
Emergency Contact Relationship
To be completed by a parent or guardian:
I, parent/guardian of the above named participant, hereby consent that they are given full permission to participate in ECO-UNESCO’s Youth For Sustainable Development Programme and in any activities associated with the programme, be they internal or external.
Yes,
I give full permission to participate
Medical Assistance
:
By signing this form, you are ECO-UNESCO to undertake appropriate first aid assistance in case of injury, accident or medical emergency.
Yes I consent
Data Protection and Privacy
:
We will not share your details with any third party except for the organization who signposted you to our services if appropriate. Your details will be maintained within our participant files, and we may contact you in the future about other ECO-UNESCO services.
Yes, I consent
Photographs and Videos
:
ECO-UNESCO may use images and/or video from our activities for publications and promotional purposes.
Yes, I consent
No, I do not consent
Contact Information