Add a service

To include a service, please fill out the form below (one form for each service).

Agency/organisation contact details

Name*

If other, please enter your Agency/Organisation Name

Department Area/Name

Please leave blank if this is not appropriate for your Agency/Organisation

Staff Member

Please provide your contact details in case we need to confirm information. Please include either a phone contact or an email contact below. This information will NOT be displayed on the directory.

Staff Phone Contact

Email Contact

Service/program details

Name*

Address

If more than one site please add the additional details below under Additional Sites. e.g. 212 Dendy Street Brighton VIC 3187

Additional Sites

If there are Additional Sites, please select the available locations. Hold down the control (ctrl) or command button to select multiple options.

Phone Number

e.g. 9888 1000

Mobile Number

e.g. 0400 000 000

Fax Number

e.g. 9888 1000

Email Address

Website Address

Facebook Address

Twitter Account

About this Service (100 words or less)*

Please provide up to 2 key sentences describing this Service/Program. Please note eligibility criteria (i.e. age or costs) is not required here as it is explicitly provided in the eligibility field. For examples, please refer to the A-Z Services listing.

Minimum Age of Participant

Please enter the minimum age as a whole number e.g. 7 (not seven), 4 if the age is 4.5. Leave blank if there is no minimum age.

Maximum Age of Participant

Please enter the maximum age as a whole number e.g. 7 (not seven), 4 if the age is 4.5. Leave blank if there is no maximum age.

Service/program categorisation

Audience*

Child (0-8 years)

Middle Years (6-12 years)

Youth (10-25 years)

Parents and Carers

Service and Education Providers (in order to tick this box must provide a direct service or support to service providers.

The audience indicates who the service is for and who will receive the service. For example: Family Life offers a service called Creating Capable Communities. This service has an audience of “Parents and Carers” because it provides a program that assists a family’s connection to their community (by targeting parents). Amaze offers a service called Helping Children with Autism. This service has an audience of “Child (0-8)” because it provides a service for the child.

Urgency/Level of Service*

Tertiary (Urgent Help): Services designed to assist with complex needs which require thorough and intensive support and responses.

Secondary (Direct Help): Services designed to work with moderate and multiple issues when more focussed support is required

Primary (Some Help): Services designed to resolve an issue in its early stages in order to stop it from progressing.

Preventive (Just Curious): Services designed to provide engagement opportunities and educate, with the intention of preventing a problem from occurring.)

Please select the Urgency Level of the Service/Program. You may tick more than one urgency level.

Select a Category*

Please select a category that best describes this Service/Program. At least one category is required.

Select an additional Category

This field is optional. However, if this Service/Program relates to additional categories, then select the most appropriate one here.

Select an additional Category

This field is optional. However, if this Service/Program relates to additional categories, then select the most appropriate one here.

Submit service/program details

Acknowledgement*

I acknowledge that I have read and understood “Is your service right for the Child and Youth Directory?” and feel this service meets the eligibility criteria to be included in the Child and Youth Directory

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