Tasmanian Leaders Inc
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I-LEAD
DRIP: Drought Resilience Impact Preparedness
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DRIP Program Acceptance Form
DRIP Acceptance Form
"
*
" indicates required fields
Your name
Name
First
Last
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Let us know what details you would like on your name badge
Preferred name, role, and the company you are representing
Preferred name
*
e.g. Ange Driver instead of Angela Driver
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Company you are representing
e.g. Tasmanian Leaders Inc.
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Role
e.g. CEO
Details of primary emergency contact
Name
*
Full name
Relationship to you
*
Partner, wife, husband, parent, brother, sister, etc.
Phone (primary)
*
Phone (secondary)
Would you like this person to make requests on your behalf?
*
Yes
No
Program Acceptance Questions
Program Dates
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I agree to attend the sessions as detailed in the program offer including the three post residential webinarsI
Terms and Conditions
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In consideration for the opportunity to participate in the 2024 DRIP program, I agree to be bound, and continue to be bound, by the Terms and Conditions published by Tasmanian Leaders which may be amended from time to time. I recognise that the Terms and Conditions impose a range of obligations on me and they also, among other things, limit any potential liability Tasmanian Leaders may have otherwise had to me.
www.tasmanianleaders.org.au/program-terms-and-conditions
Participant charter
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I will show professional respect to my fellow participants, facilitators and all guests of the program.
I-LEAD participant charter
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I will read any materials provided before the program commences and will complete and participate in ongoing evaluations as requested.
I-LEAD participant charter
*
I will strive to actively participate in leadership development to improve my sector and influence a more successful future for Tasmania. I will assist with the promotion and development of Tasmania and the Tasmanian community regardless of where in the world I may be based from time to time. I will support the work of Tasmanian Leaders as a graduate of this program and as part of the Network.
Medical, dietary, and accessibility
We want to ensure we are able to support your participation in the program
I have a medical condition that may impact my participation
I have dietary restrictions / allergies
I have accessibility requirements
If you have a medical condition, please detail the potential impact of the illness or condition on your ability to participate, and any adjustments we may need to provide
*
If you have dietary requirements or allergies, please provide (such as vegetarian/vegan, coeliac etc)
*
If you have accessibility needs, please provide details (such as access to venues, capacity to sit for long periods etc)
*
Are you happy to share a room with someone of the same gender?
Yes
No
Maybe
Age in years (on acceptance of place on program)
Please enter a number from
20
to
80
.
Communicate and share information during the program
To enable us to communicate and share documents with you during your program experience, we will be establishing a Microsoft Teams account. To help set this up, please confirm the email you would like the account invitation to be sent to? This email will be used for log ins and notifications. If you already have a Microsoft Teams account you might like to use the same email address.
Please supply the primary email address you used to apply to the program
*
The email address you received the form link from
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Would you like to use the same email address for Microsoft Teams?
*
Yes
No, I would like to use an alternate email
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If no, please supply an alternate email address
*
A little bit more information
Photo
Please upload a recent photo (headshot), this will be used to share with participants at the start of the program, and Tasmanian Leaders staff.
File
*
Accepted file types: jpeg, tiff, png, Max. file size: 64 MB.
Bio
*
Please provide a short 100 word bio about yourself and your career.
Consent
I give consent to Tasmanian Leaders to share my mobile number and email with my fellow participants
I agree to attend the sessions as detailed in the program offer I received
I will show professional respect to my fellow participants, facilitators and all guests of the program.
I will read any materials provided before the program and participate fully in every session, and undertake any pre task activities.
I agree to complete and participate in ongoing evaluations as requested.
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