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2024 - 2025 Regional Leadership Development Program Registration Form

Personal Information

Please check the criteria before you apply to see if you are eligible for this program and its streams.
1.First Name:(Required.)
2.Last Name:(Required.)
3.Contact phone number:(Required.)
4.Contact email address:(Required.)
5.What is your residential postcode?(Required.)
6.In which Local Government Area of South Australia do you reside?(Required.)
7.What is your gender?(Required.)
8.Are you of Aboriginal or Torres Strait Islander origin?(Required.)
9.Do you have a culturally and linguistically diverse background?(Required.)
10.Do you have a disability?(Required.)
11.What is your current labour force status?(Required.)
12.What is your highest level of educational attainment?(Required.)
13.What is your current (or most recent) industry of employment?(Required.)