Thank you for your interest in the Next25 Leadership Course.

To register and to be considered for a Next25 Scholarship worth $4,000, please fill out this short registration. All applications will be treated confidentially. Once approved, you will receive an invoice for a total of $1,000 + GST to confirm your place on the program.

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* 1. Please select which course you are registering for.
By selecting more than one answer you are indicating you are available for multiple course dates. Dates are occasionally subject to change due to parliamentary calendars.

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* 2. Please select which location you would prefer.
Whilst we do our best to take location preference into account, please bear in mind your preferred dates may not align with your preferred location. By selecting more than one location, you are indicating you are available for multiple locations.

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* 3. The course dates are to be confirmed once all sitting calendars are released and are viable for most registered participants.

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* 4. What is your full name?

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* 5. What is your local phone number?

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* 6. What is your mobile phone number?

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* 7. What is the best email for us to use to communicate with you?

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* 8. Do you have any dietary requirements?

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* 9. Briefly outline why you would like to undertake the Next25 Leadership Course. (100 words)

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* 10. In what ways will your participation in the Leadership Course benefit you and/or your constituency? (150 words)

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* 11. Describe the way you perceive your role as a leader (200 words)

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* 12. What is your biggest challenge as a leader right now? (100 words)

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* 13. If you could affect one change to the system of parliament and/or politics as a whole, what would you choose and why? (100 words)

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* 14. Was a colleague’s recommendation persuasive in your decision to sign up for this program?

Thank you for your responses and your interest in Next25 Leadership. You will hear back from Next25 within a fortnight with regard to your application. If you have any other questions in the meantime, please don't hesitate to contact Stephanie Mason, Program Manager at stephanie@Next25.org.au

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