I-LEAD Application

Please confirm which I-LEAD program you are applying for*

This program is not taking applications at present, please proceed with the application and we will note your interest and inform you when a program is available.

PERSONAL DETAILS

Your details

Title*

Name*

First Last

Preferred Name

Gender*

Gender refers to current gender, which may be different to sex recorded at birth and may be different to what is indicated on legal documents.

If other, please specify*

What pronouns do you use?*

Date of birth*

Format: dd/mm/yyyy

Phone

Mobile*

Home Phone

Work Phone

Email addresses

Email address*

Secondary email address

LinkedIn profile address

MORE ABOUT YOU

Residential address

Location*

Street Address Suburb State Postcode Country

Postal address

Same as residential address

Use residential address as postal address

Street Address Suburb State Postcode Country

Do you identify as an Australian Aboriginal and/or Torres Strait Islander person?*

How would you describe your cultural background? (Please select up to 2 cultural backgrounds)*

Your cultural background is the cultural/ethnic group(s) to which you feel you belong or identify. This background may be the same as your parents, grandparents, or your heritage, or it may be the country you were born in or have spent a great amount of time in, or you feel more closely tied to.

Apart from English, in which language(s) could you have a conversation about a lot of everyday things?*

How did you hear about this program?

Hidden

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EMPLOYMENT

Current employer

Employer name*

Position held*

Start date

Employer's website

Employer's postal address

Street Address Suburb State Postcode Country

Size*

Employment sector*

Public sector (additional information)*

Industry*

Other industry*

Occupation*

Other occupation*

Role category

Other role category

Briefly describe your role and responsibilities, outlining your annual budget, your team size and the number of direct reports*

INFORMATION FOR THE SELECTION PANEL

Please let us know you meet the eligibility criteria for this program.*

Please outline any previous experience you have had in leadership roles or leadership development programs.*

Explain why you wish to participate in this program and what you hope to gain from your participation.*

COMMUNITY AND SECTOR INVOLVEMENT

Describe any volunteer or pro-bono activity you are currently involved in*

What do you feel are the three most important challenges facing your sector today?*

What are three opportunities available to your sector?*

How are you, or might you, contribute to seize these opportunities?*

REFEREE

Please provide details for a referee knowledgeable about your leadership performance and potential. The person should be from your industry or organisation, and we ask that you avoid direct family members. Your referee must be willing to answer a number of questions via an online form. This will be sent to them shortly after submission of your application. We encourage you to speak to them prior so they are prepared.

Referee

Title

Name*

First Last

Relationship to you*

Time known

Organisation name

Job title

Email address*

Mobile

Tasmanian Leaders Inc