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Women's Community Sport Leadership Program- Expression of Interest

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1. Your Details:

Name

Employer / Sports Organisation

Residential Postal Code

Email Address

Phone Number

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2. Gender:

Woman

Man

Prefer not to say

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3. How long have you been employed or volunteered in community sport?

Less than 1 year

1-2 years

2-5 years

5-10 years

10 plus years

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4. What are your current roles in sport? Please include organisation name and role.

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5. Which Local Government Area is your organisation located in?

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6. Are you currently involved in any other leadership programs?

Yes

Unsure

Please list the name of the program as required:

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7. Considering that this leadership program is designed to discuss and better understand gender equity issues in community sport across Gippsland, please rate yourself on a scale of 0-10 for the following statements:

	(Lowest) 0	1	2	3	4	5	6	7	8	9	(Highest) 10
I am aware of my responsibilities and what I could/need to do to address this topic	I am aware of my responsibilities and what I could/need to do to address this topic (Lowest) 0	I am aware of my responsibilities and what I could/need to do to address this topic 1	I am aware of my responsibilities and what I could/need to do to address this topic 2	I am aware of my responsibilities and what I could/need to do to address this topic 3	I am aware of my responsibilities and what I could/need to do to address this topic 4	I am aware of my responsibilities and what I could/need to do to address this topic 5	I am aware of my responsibilities and what I could/need to do to address this topic 6	I am aware of my responsibilities and what I could/need to do to address this topic 7	I am aware of my responsibilities and what I could/need to do to address this topic 8	I am aware of my responsibilities and what I could/need to do to address this topic 9	I am aware of my responsibilities and what I could/need to do to address this topic (Highest) 10
I am confident I can complete & address what I need to do for this topic	I am confident I can complete & address what I need to do for this topic (Lowest) 0	I am confident I can complete & address what I need to do for this topic 1	I am confident I can complete & address what I need to do for this topic 2	I am confident I can complete & address what I need to do for this topic 3	I am confident I can complete & address what I need to do for this topic 4	I am confident I can complete & address what I need to do for this topic 5	I am confident I can complete & address what I need to do for this topic 6	I am confident I can complete & address what I need to do for this topic 7	I am confident I can complete & address what I need to do for this topic 8	I am confident I can complete & address what I need to do for this topic 9	I am confident I can complete & address what I need to do for this topic (Highest) 10
I am aware of tools and resources available to support my work to address this topic	I am aware of tools and resources available to support my work to address this topic (Lowest) 0	I am aware of tools and resources available to support my work to address this topic 1	I am aware of tools and resources available to support my work to address this topic 2	I am aware of tools and resources available to support my work to address this topic 3	I am aware of tools and resources available to support my work to address this topic 4	I am aware of tools and resources available to support my work to address this topic 5	I am aware of tools and resources available to support my work to address this topic 6	I am aware of tools and resources available to support my work to address this topic 7	I am aware of tools and resources available to support my work to address this topic 8	I am aware of tools and resources available to support my work to address this topic 9	I am aware of tools and resources available to support my work to address this topic (Highest) 10
I have the confidence to make improvements in my work around this topic	I have the confidence to make improvements in my work around this topic (Lowest) 0	I have the confidence to make improvements in my work around this topic 1	I have the confidence to make improvements in my work around this topic 2	I have the confidence to make improvements in my work around this topic 3	I have the confidence to make improvements in my work around this topic 4	I have the confidence to make improvements in my work around this topic 5	I have the confidence to make improvements in my work around this topic 6	I have the confidence to make improvements in my work around this topic 7	I have the confidence to make improvements in my work around this topic 8	I have the confidence to make improvements in my work around this topic 9	I have the confidence to make improvements in my work around this topic (Highest) 10
I have the knowledge & skills to improve my work to address this topic	I have the knowledge & skills to improve my work to address this topic (Lowest) 0	I have the knowledge & skills to improve my work to address this topic 1	I have the knowledge & skills to improve my work to address this topic 2	I have the knowledge & skills to improve my work to address this topic 3	I have the knowledge & skills to improve my work to address this topic 4	I have the knowledge & skills to improve my work to address this topic 5	I have the knowledge & skills to improve my work to address this topic 6	I have the knowledge & skills to improve my work to address this topic 7	I have the knowledge & skills to improve my work to address this topic 8	I have the knowledge & skills to improve my work to address this topic 9	I have the knowledge & skills to improve my work to address this topic (Highest) 10
I am ready to make improvements in our workplace around this topic	I am ready to make improvements in our workplace around this topic (Lowest) 0	I am ready to make improvements in our workplace around this topic 1	I am ready to make improvements in our workplace around this topic 2	I am ready to make improvements in our workplace around this topic 3	I am ready to make improvements in our workplace around this topic 4	I am ready to make improvements in our workplace around this topic 5	I am ready to make improvements in our workplace around this topic 6	I am ready to make improvements in our workplace around this topic 7	I am ready to make improvements in our workplace around this topic 8	I am ready to make improvements in our workplace around this topic 9	I am ready to make improvements in our workplace around this topic (Highest) 10

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8. I have read and understood the information provided about this women's leadership program and that will run until December 2021.

Yes

Unsure

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* 1. Your Details:

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* 2. Gender:

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* 3. How long have you been employed or volunteered in community sport?

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* 4. What are your current roles in sport? Please include organisation name and role.

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* 5. Which Local Government Area is your organisation located in?

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* 6. Are you currently involved in any other leadership programs?

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* 7. Considering that this leadership program is designed to discuss and better understand gender equity issues in community sport across Gippsland, please rate yourself on a scale of 0-10 for the following statements:

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* 8. I have read and understood the information provided about this women's leadership program and that will run until December 2021.

1. Your Details:

2. Gender:

3. How long have you been employed or volunteered in community sport?

4. What are your current roles in sport? Please include organisation name and role.

5. Which Local Government Area is your organisation located in?

6. Are you currently involved in any other leadership programs?

7. Considering that this leadership program is designed to discuss and better understand gender equity issues in community sport across Gippsland, please rate yourself on a scale of 0-10 for the following statements:

8. I have read and understood the information provided about this women's leadership program and that will run until December 2021.