Tasmanian Emerging Aboriginal Leaders (TEAL) program

PERSONAL DETAILS

Your details

Name(Required)

First Last

Preferred Name

Gender(Required)

Date of birth(Required)

Format: dd/mm/yyyy

Phone

Mobile(Required)

Work Phone

Email addresses

Email address(Required)

Secondary email address

Residential address

Street Address Suburb State Postcode Country

Location(Required)

Postal address

Same as residential address

Use residential address as postal address

Street Address Suburb State Postcode Country

How did you hear about this program?

Hidden

zap_id

EMPLOYMENT

Current employer

Employment sector(Required)

Employer name

Employer's website

Position held

Length of time in role?

Employer postal address

Street Address Suburb State Postcode Country

Briefly describe your role and responsibilities

INFORMATION FOR THE SELECTION PANEL

Please outline your leadership experience or ambition(Required)

Please outline your commitment to participate in the program and work with, learn form and share with others(Required)

Please outline your potential to contribute to your organisation and wider community after the program(Required)

Please confirm you have the support from your organisation and/or community to participate(Required)

COMMUNITY AND SECTOR INVOLVEMENT

Describe any volunteer or community activity you are currently involved in

What do you feel are the most important challenges and opportunities facing your community today?

How are you, or might you, use leadership to address these challenges and opportunities?

REFEREE

Please provide details for a referee knowledgeable about your leadership performance and potential. 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(Required)

First Last Suffix

Relationship to you(Required)

Time known

Job title

Organisation name

Email address(Required)

Mobile

COMMITMENT

Payment(Required)

My employer will be paying the full fee of $1,330

I will be paying the full fee $1,330

I would like to enquire about a scholarship

Who should we invoice?

Name(Required)

First Last

Job title

Contact email(Required)

Primary phone

Alternate phone

Scholarship supplementary question(Required)

If enquiring about a scholarship, please tell us why you and your employer can not afford the full fee.

Commitment(Required)

I confirm that the information provided in this application is true and correct

I confirm that I understand the time commitment required to participate in this program

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Tasmanian Leaders Inc

Tasmanian Emerging Aboriginal Leaders (TEAL) program

TEAL - Tasmanian Emerging Aboriginal Leaders program application

PERSONAL DETAILS

Your details

Phone

Email addresses

Residential address

Postal address

EMPLOYMENT

Current employer

INFORMATION FOR THE SELECTION PANEL

COMMUNITY AND SECTOR INVOLVEMENT

REFEREE

Referee

COMMITMENT

Who should we invoice?