Application form

Leadership WA’s Aspiring Leadership Course

Name*
First Last
Email*
Phone*
Company*
Job Title*
Where did you hear about us?*
Which intake are you signing up for?*
- October
What is your reason for attending?*
What would you like to learn about leadership that would help you grow as a leader?*
How would you describe the type of leader you would want to follow?*
For example, what characteristics they would have?
What other (if any) leadership courses have you done?*
What is your definition of leadership?*
I have a Disability*
- Yes
- No
Please provide details of any assistance required to attend the Aspiring Course*
Do you have any dietary requirements?*
- Yes
- No
Please provide details of your dietary requirements.*
Emergency contact name*
First Last
Emergency contact phone (primary)*
Emergency contact phone (secondary)
Emergency contact relationship*
Payment method*
- Credit Card
- Invoice
- LeadAbility Scholarship
A limited number of LeadAbility Scholarships are available, thanks to the Department of Communities (Disability Services), for participants who have a disability or lived experience. In addition, those working in or advocating for the sector will also be considered and are invited to consider applying.
Terms and conditions*
I agree to the terms and conditions.
Aspiring Leadership Course*
Price:
Name of Person/ Organisation to be invoiced*
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