TEEN TEAM SUPPORT GROUP - Application forms

Teen Team Support Group - Application Form

Date ______________________

To be filled in by Parent/Guardian/Caretaker

Name of Parent/Guardian/Caretaker _________________________
Home Telephone Number _________________________
Mobile Telephone Number _______________________
Email Address ________________________________

Name of Child (BLOCK LETTERS) __________________
Home Address ________________________________
Current School/Educational Institution the Teen is attending ___________________________________________

Does the child have a developmental or medical condition? If YES please state what it is so that we can better cater for his/her individual needs.

___________________________________________

Does the child have any psychological, emotional or behavioural difficulties? If YES please state what it is/they are so that we can better cater for his/her individual needs.
___________________________________________

Is the child independent enough to engage in group work and communicate with other people?
___________________________________________

Is there anything else you will like the facilitators of Teen Team to know? ___________________________________________

Are you willing to devote some time to help Teen Team? ___________________________________________

What would you like to see during Teen Team sessions? ___________________________________________

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Teen Team Support Group - Application Form

To be filled in by Teens

So let us know a little bit about yourself…. You see we are trying to make TT sessions as good as possible for you and we need your ideas and opinions. What will you like Teen Team to be about? We ask you to spend some time filling in the form below. It shouldn’t take much time and plus you will make that little contribution to TT as well. Don’t worry it’s not so long :)

Date ____________________________________
Name of Teen______________________________
Email : ___________________________________

In my life I like_____________________________
________________________________________
I don’t like ________________________________
________________________________________
I am good at _______________________________
________________________________________
I have problems with _______________________
________________________________________
My hobbies are _____________________________
________________________________________
I’d like to become better in _____________________
________________________________________
In Teen Team I would like to see _________________
________________________________________