Civil Society Leadership Development Program

Complete this form to apply for participation in the Program.

Application Form

Name  

Email  

Phone  (bh)     Phone (ah) 


Address  

 

  I would like to participate in the Civil Society Leadership Development
Program in 2016.


Tell us how you meet the four criteria for participating in this Program:

    1. face challenges in their personal, family, community or social circumstances for which innovative social solutions are required (participants must nominate two such challenges)


 

    2. are working with peers and colleagues in a voluntary capacity in seeking solutions




    3. have an interest in acquiring new ideas, approaches, insights and skills, and learning from others



   
4. want to exercise leadership in assisting others in developing solutions.


Tell us how you think you would benefit from participating in this Program:


 

  I understand that the Registration Fee is $220.
 I will pay this Fee on acceptance into the Program.

I will
  pay by EFT
  forward a cheque by mail
  Please send a tax invoice for payment to:
Social Enterprise Partnerships Ltd.
ABN: 47 108 742 098

Payment Options:
EFT
(Commonwealth Bank of Australia  Account name: Social Enterprise Partnerships Ltd
BSB: 062 218  Account number: 1007 2945)

Cheque
(
payable to Social Enterprise Partnerships Ltd, mail to PO Box 159 Yarraville Vic 3013)
 

Please tell us the names and contact details of two referees who will be
able to tell us how you would benefit from participating in this Program:


 


mailto:federation@civilsociety.org.au
Enquiries:

0425 722 890