Tasmanian Leaders Inc

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Program Acceptance Survey

I-LEAD Program Acceptance

"*" indicates required fields

Your name

Name

Let us know what details you would like on your name badge

Preferred name, role, and the company you are representing
e.g. Ange Driver instead of Angela Driver
e.g. Tasmanian Leaders Inc.
e.g. CEO

Details of primary emergency contact

Full name
Husband, wife, partner, parent, brother, sister, etc.
#### ### ### or landline ## #### ####
#### ### ### or landline ## #### ####

Program Acceptance Questions

Program Dates*
Terms and Conditions*
https://www.tasmanianleaders.org.au/i-lead-terms-and-conditions/
Participant charter*
I-LEAD participant charter*
I-LEAD participant charter*
I-LEAD participant charter*

Medical, dietary, and accessibility

We want to ensure we are able to support your participation in the program

Communicate and share information during the program

To enable us to communicate and share documents with you during your program experience, we will be establishing a Microsoft Teams account. To help set this up, please confirm the email you would like the account invitation to be sent to? This email will be used for log ins and notifications. If you already have a Microsoft Teams account you might like to use the same email address.
The email address you received the form link from

A little bit more information

Photo

Please upload a recent photo (headshot), this will be used to share with participants at the start of the program
Max. file size: 64 MB.

Consent
Participation
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.

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