Apply or Refer to Switch 2 Music Studio
  1. First Name(*)
    Invalid Input
  2. Last Name(*)
    Invalid Input
  3. Date of Birth(*)
    Invalid Input
  4. House Number and Street
    Invalid Input
  5. Address Line 2
    Invalid Input
  6. Town/City(*)
    Invalid Input
  7. Post Code
    Invalid Input
  8. Email(*)
    Invalid Input
  9. Telephone(*)
    Invalid Number
  10. Referrer name
    Invalid Input
  11. Referrer organisation
    Invalid Input
  12. Referrer email
    Invalid Input
  13. Referrer number
    Invalid Input
  14. Tell us a bit about you, or the reason for your referral, including any music experience.(*)
    Invalid Input
  15. Risks
    Invalid Input
    Are there any identified risks associated with this applicant? Please include criminal convictions, medical issues and any problems with drugs and/or alcohol.
  16. Declaration (*)
    Invalid Input
    If the young person is under 18 they may need an adult to go through this section to make sure they fully understand it. As far as I am aware the information I have given about myself is true and correct, providing false information could result in removal from any SYMCA programmes. For SYMCA to assess your application we may need to check the information on your application for with external agencies and partners who could be, but not limited to; parent/carer; Social Services; Probation Service, Youth Offending Team; YPDAT; schools/colleges; other relevant persons or organisations. Please check this box to show that you understand that SYMCA may need to obtain information to process your application and that you give consent for us to do this.
  17. Newsletter
    Invalid Input
    If checked - Please send me email updates with new opportunities and projects.

  18. Invalid Input
    Please complete to show you are a real person.

Copyright © 2016 Southend-on-Sea YMCA. All Rights Reserved.
Southend YMCA is registered as a charity under No 1102837 and is registered as a company in England under No. 5051166.
Southend YMCA is an independent Southend based charity that is affliated to the national and global YMCA movement, supporting children and young people.
Head office: Southend YMCA, Newlands, 85 Ambleside Drive, Southend-on-Sea, Essex SS1 2FY

The Southend YMCA website uses cookies. By continuing to access the site you are agreeing to their use. To find out more about the cookies we use and how to delete them, see our privacy policy.

I accept cookies from this site.

EU Cookie Directive Module Information