Victorian Rural Women’s Network Leadership and Mentoring Program - Application Form for Women Leading Now Survey

The funded places are for the first delivery of Women Leading Now (29 Jul, 03 & 04 Aug 2021).

The application form may take up to 30 minutes to complete. As this needs to be done in one session, please review the application form questions before starting.

Please limit responses to 150 words each.

If you experience any accessibility issues with this application form, please email info@leadershipvictoria.org

Submit your application by 5pm, Monday 14 June.

Given name:(Required.)

Family name(Required.)

Preferred pronoun

Phone number(Required.)

Email Address(Required.)

Home Address(Required.)

LinkedIn Profile

The following question is optional and will not affect the outcome of your application. This information helps us to understand the diversity of our applicants.

Do you identify as:

Aboriginal and/or Torres Strait Islander

Living with a disability

Part of LGBTIQ communities

As part of your cultural heritage, do you speak languages other than English

Describe your connection with agriculture/the agricultural supply chain.(Required.)

How did you hear about Women Leading Now and the VRWN Leadership and Mentoring Initiative?(Required.)

If you heard about it from a previous program participant, who?

What attracts you to this program?(Required.)

Please list up to three educational qualifications (course, year, institution)(Required.)

Please list up to three other significant learning and development or training activities you have undertaken in the past 7 years.(Required.)

Are you currently employed?(Required.)

Yes