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Referrer’s Details – Please complete the relevant section if you are a parent/guardian, professional working with the Young Person Mentee, or other person completing this enquiry.
Authorisation and Declaration
I declare that the information I have provided in this young person mentee's Referral Enquiry Form is true and correct. I agree, as a condition of my child’s engagement with BBBSA, that:
In relation to my child’s application, BBBSA may collect personal and sensitive information as part of the application process and, from time to time, during his or her engagement with BBBSA.
I am required to inform BBBSA of any changes to mine or my child’s circumstances during his or her involvement in the program;
All personal and sensitive information collected by BBBSA as part of the application process is for the purpose of determining whether the young person mentee is suitable to join the program and to enable BBBSA to retain appropriate information to deal with any future legal liability which may arise in relation to the child’s engagement with BBBSA;
Any agencies, individuals or other entities such as (but not limited to) educational institutions, law enforcement agencies, social services, other BBBSA agencies and other such entities with which my child has had contact, may release any information about, or relating to, him or her as requested by BBBSA which may be relevant to their involvement with BBBSA;
If my child’s application is successful, BBBSA will retain his or her personal information for the duration of their engagement as a mentee and for the life of the file, which may be up to 100 years. If my child’s application is unsuccessful, BBBSA will securely dispose of all personal and sensitive information relating to my child’s application after 12 months, unless required for legal reasons.
Collection and retention of my child’s personal information is required as a condition of his or her engagement with BBBSA and BBBSA may refuse the application or terminate my child’s engagement with the program if my consent is not provided;
A photocopy of this authorisation is sufficient evidence of my consent to the release of any information about, or relating to, my child to BBBSA.
Unless I contact BBBSA to request otherwise, my child’s personal information will be included in the BBBSA young person mentee database hosted in Australia. I acknowledge that while BBBSA has taken steps to protect this personal information, BBBSA will not be accountable for overseas recipients under the Privacy Act and that I may not be able to seek redress under the Privacy Act.
If I am not the parent/guardian to the young person mentee referred to above I have received consent from the parent/guardian to submit the online referral enquiry on their behalf and they are aware and agree to their child's details being added to the BBBSA Young Person Mentee database hosted in Australia.
By clicking ‘submit’ I agree to the terms above, including the Authorisation and Declaration.
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