Tasmanian Leaders Inc
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Bequests
I-LEAD Pride Program Acceptance
I-LEAD Pride Program Acceptance
"
*
" indicates required fields
Your details for our participant handbook
Legal Name
*
First
Last
Preferred Name
*
First
Last
Pronouns
*
eg She / her, He / him, They / their, He / they, She / they
Mobile number
*
Preferred phone number for program communication
Email
*
Preferred email for program communication
Let us know what details you would like on your name badge
Preferred name, pronouns, role, and the company you are representing
Preferred name
e.g. Ange Driver instead of Angela Driver
Do you want your pronouns on your name badge?
——
Yes
No
Do you want your role and organisation on your name badge?
——
Yes
No
Role
e.g. CEO
Organisation you are representing
e.g. Tasmanian Leaders Inc.
Details of primary emergency contact
Name
*
Full name
Relationship to you
*
Husband, wife, partner, parent, brother, sister, etc.
Phone (primary)
*
#### ### ### or landline ## #### ####
Phone (secondary)
#### ### ### or landline ## #### ####
Would you like this person to make requests on your behalf?
*
——
Yes
No
Reasonable adjustments and support
Do you have any dietary requirements, allergies or medical conditions?
Yes
No
Please provide details. We will contact you if we need any further information.
Do you require any reasonable adjustments or other support to enable you to participate fully in the program?
Yes
No
Please tell us what adjustments or support would be helpful. We will contact you if we need any further information.
A little bit more information about you
Bio
*
Please submit a short 100-150 word bio about yourself that we will share with fellow participants. NOTE: Please write your bio in the third person
Photo
*
Please upload a headshot that we can include with your bio. Preferred formats are jpeg, png or svg. We prefer a full colour, squared image, with plenty of space around your head and shoulders
Max. file size: 64 MB.
Program Acceptance Questions
Participation
*
I will undertake to attend all program sessions as outlined in my letter of offer. I understand that full benefit from the program can only be gained by full attendance and I acknowledge the expectation that participants will only be absent from program sessions in exceptional circumstances and any absence greater than 20% will impact my abilty to graduate. In the unlikely event that such circumstances arise, I understand this may impact my eligibility to graduate from the program.
I agree to attend all program sessions.
Participant charter
*
I will show professional respect to my fellow participants, facilitators and all guests of the program.
I-LEAD participant charter
*
I will read any materials provided before each session and participate fully in every session I attend. Undertake any pre task activities. Complete and participate in ongoing evaluations as requested.
I-LEAD participant charter
*
I will undertake to attend all program sessions. I understand that full benefit from the program can only be gained by full attendance and I acknowledge the expectation that participants will only be absent from program sessions in exceptional circumstances. In the unlikely event that such circumstances arise, I understand this may impact my eligibility to graduate from the program and join the Tasmanian Leaders Network.
I-LEAD participant charter
*
I will strive to actively support and participate in Tasmania’s LGBTIQA+ communities
Access Bursary acknowledgement
*
I acknowledge that if I have received an access bursary, I will: 1) Complete a bursary acquittal declariing I have spent the funds in line with their intended purpose. 2) If I do not complete the program, I may need to repay the bursary.
I agree
Your Privacy and Consent
Terms and Conditions
*
In consideration for the opportunity to participate in the 2026 I-LEAD Pride program, I agree to be bound, and continue to be bound, by the Terms and Conditions published by Tasmanian Leaders which may be amended from time to time. I recognise that the Terms and Conditions impose a range of obligations on me and they also, among other things, limit any potential liability Tasmanian Leaders may have otherwise had to me.
https://www.tasmanianleaders.org.au/i-lead-terms-and-conditions/
Consent
*
Once you have reviewed the Terms and Condistions, please select from the below options to confirm your consent for us to share information, whilst ensuring your privacy is maintained.
I give consent to Tasmanian Leaders to share my contact details with fellow participants
I give consent to Tasmanian Leaders to share my bio and details of my role with fellow participants
I give consent to Tasmanian Leaders to record my participation in the program (eg. the annual Yearbook)
I give consent to Tasmanian Leaders to share my image in public communications and marketing materials
Select All
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