YMCP APPLICATION + Baseline Survey

My Details
Address
Other Information
What do you hope this program will help you with?

Media Consent

By ticking yes, you are authorising MMVLLEN to use and print photographs and any other form of media material for educational, informational and promotional purposes. Images may be used, but is not limited to, MMVLLEN publications and newsletters, newspaper articles, advertising material, web listings, websites etc. 

This media consent will be kept on file by MMVLLEN as reference for individual approval.

Page 4








Education






Resume