Tasmanian Leaders Inc
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Program Acceptance Survey
I-LEAD Program Acceptance
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*
" indicates required fields
Your details for our participant hand book
Name
*
First
Last
Mobile number
*
Preferred email for program communication and to be shared with program peers.
Email
Preferred email for program communication and to be shared with program peers.
LinkedIn
*
Please provide your LinkedIn profile URL, as we’ll be setting up a closed group to share program materials and encourage group dialogue. If you don’t have a LinkedIn account, we encourage you to create one to support your engagement in the program.
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Email for Microsoft Teams
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.
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Which program have you been accepted into?
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I-LEAD Women in Industry
I-LEAD Not-for-profit
I-LEAD Tourism & Hospitality
I-LEAD Small Business
Leading Australian Resilient Communities (LARC)
Let us know what details you would like on your name badge
Preferred name, role, and the company you are representing
Preferred name
e.g. Ange Driver instead of Angela Driver
Organisation you are representing
e.g. Tasmanian Leaders Inc.
Role
e.g. CEO
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?
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Yes
No
Program Acceptance Questions
Program Dates
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I agree to attend the sessions as detailed in the program offer I received
Terms and Conditions
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In consideration for the opportunity to participate in the 2025 I-LEAD 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. I also understand that by submitting this form and accepting a place on the 2025 I-LEAD program I am committing to paying the participant fee (unless a scholarship has been confirmed).
https://www.tasmanianleaders.org.au/i-lead-terms-and-conditions/
Participant charter
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I will show professional respect to my fellow participants, facilitators and all guests of the program.
I-LEAD participant charter
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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 participate in industry development to improve my sector and influence a more successful future for Tasmania. Assist with the promotion and development of Tasmania and the Tasmanian community regardless of where in the world I may be based from time to time. As well as supporting the work of Tasmanian Leaders more broadly.
Medical, dietary, and accessibility
We want to ensure we are able to support your participation in the program
I have a medical condition that will impact my participation
I have dietary restrictions
I have accessibility needs to allow me to fully participate
If you have a medical condition, please detail the dates, duration and outcome of the illness or condition
*
If you have dietary requirement, please detail and include dietary choices such as vegetarian/vegan
*
If you have accessibility needs, please detail things that might affect access to venues, capacity to sit for long periods etc
*
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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.
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Please supply the primary email address you used to apply to the program
*
The email address you received the form link from
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Would you like to use the same email address for Microsoft Teams?
*
Yes
No, I would like to use an alternate email
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If no, please supply an alternate email address
*
A little bit more information
Bios
*
Please submit a short 100-150 word bio about your career that we will share with fellow participants.
Photo
*
Please upload a headshot that we can include with your bio.
Max. file size: 64 MB.
Consent
*
I give consent to Tasmanian Leaders to share my mobile number, email and Linkedin with my fellow participants
www.tasmanianleaders.org.au/i-lead-terms-and-conditions
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.
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