StrideMentor - Mentee Application

Thanks for your interest in StrideMentor, a program offered to young women born in 2012 and 2013.

Places in the program are limited and selections will be made following closure of the application period. Selections for StrideMentor are discretionary and will be completed by a panel including at least one representative from each of Little Athletics Victoria and Athletics Victoria. Performance will not be a determinant of a member’s eligibility for entry into this program.

Please ensure you complete this form with a parent or guardian.

To apply to be involved, please complete the below form. By registering your interest, you consent to the collection, use, and sharing of your personal information between Little Athletics Victoria and Athletics Victoria, its member association(s), program researchers, and grant funding organisations. Such information includes, but is not limited to, name, date of birth, postcode, phone number, email address, gender, membership status, and/or qualifying questions as included herein.
PERSONAL INFORMATION
Personal Information(Required.)
To ensure that mentors can appropriately cater to selected participants, can you please advise if you have a disability
Is there any other information that you would like to share about your disability?
Parent/Guardian Contact Details(Required.)
AFFILIATION
Little Athletics Victoria and Athletics Victoria Club Membership(s)(Required.)