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Women Leading Locally acceptance

We are very pleased to offer you a fully funded place on the Women Leading Locally Fellowship for 2023. Please fill out the form below to accept your offer and register for the program.

Please ensure that you have read the Code of Conduct prior to accepting your position in the program.

Name

First Name

Last Name

Email *

Please submit a bio of yourself for the program. This should be 50 words max. *

50 words left

Please upload a photo of you to accompany your bio. (High resolution JPEG)

Do you require a hotel room to be booked free of charge in Melbourne CBD for the night of Saturday 17th June after the kick off seminar and networking dinner? *

Do you require financial support to travel to the kick off event in Melbourne CBD on Saturday 17th June? *

Do you have any dietary requirements? *

None

Vegetarian

Vegan

Gluten free/coeliac

Dairy/lactose free

Fish and shellfish allergy

Halal

Other

Please provide more information so we can accommodate for you. *

Do you have any access requirements? *

Yes

No

Please provide more information so we can accommodate for you. *

Please select YES here if you are happy to share your email and phone number with the other women in this Fellowship cohort. *

If you'd prefer to NOT have your photograph taken at the kick off event please select no. If you are happy to be photographed, skip this question.

Agreement *

By ticking this form, I acknowledge I have reviewed the dates and agree to attend at least 8 of the 10 online masterclasses and the kick-off event on 17th June 2023.

Agreement *

By ticking this form I acknowledge I have sufficient internet access and already have a Zoom account, or have created one to attend this online program.

Agreement *

By ticking this form I acknowledge I have read the code of conduct and agree to abide by it.

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