Service Information Collection Form

Please read “Is your service right for the Child and Youth Directory?”  before filling out this form.

The Child and Youth  Directory captures information about services. This helps to ensure people find the right service.

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

For example, the City of Stonnington Youth Services completed 5 separate forms to represent all of their services.

Agency/organisation contact details
Please leave blank if this is not appropriate for your Agency/Organisation
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.
Service/program details
If more than one site please add the additional details below under Additional Sites. e.g. 212 Dendy Street Brighton VIC 3187
If there are Additional Sites, please select the available locations. Hold down the control (ctrl) or command button to select multiple options.
e.g. 9888 1000
e.g. 0400 000 000
e.g. 9888 1000
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.
Extended service/program information
This indicates appointments are not required and people are welcome to drop in to access the service
This indicates the service can be delivered at a range of sites including homes and/or community spaces.
Please list the Languages (other than English) if you answered yes to the previous question.
Please upload a logo or image that you would like to be displayed alongside the information about this Service. Images are required to be JPEG/PNG.
Please upload a logo or image that you would like to be displayed alongside the information about this Service. Images are required to be JPEG/PNG.
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.
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 participation
Please provide any additional age criteria. e.g. "Provides services to 12 to 18 year olds in City of Kingston, Port Phillip, Stonnington, Glen Eira or Bayside", "Provides services to 18 to 25 year olds in the City of Glen Eira (north of North Road), Stonnington and Port Phillip.", "Children must be aged 18 and under."
Please add each item on a new line. Some examples include: Must work, live or study in the City of [insert]; Requires a formal mental health diagnosis; Targeted to males only; Requires membership
Please specify the additional Participation Type details, e.g. "Court Orders".
Indicates the Service/Program provides consultative service to other service providers.
Only if different to contact details
Note: PDF forms will not be accepted.
Service/program categorisation
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.
Please select the Urgency Level of the Service/Program. You may tick more than one urgency level.
Please select a category that best describes this Service/Program. At least one category is required.
This field is optional. However, if this Service/Program relates to additional categories, then select the most appropriate one here.
This field is optional. However, if this Service/Program relates to additional categories, then select the most appropriate one here.
Indicates the geographic area(s) where the Service/Program can be provided /accessed (NOT where the service building is located).
Submit service/program details