Tasmanian Leaders Program Application Form

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1Personal Details

2Employment

3Education

4Achievements

5About You

6Community

7Issues and Leadership

8You & TLP

9Referees

10Submit

Personal Details

Your details

Name*

First Last

Preferred name

This name will appear on your name badge

Gender*

Gender refers to current gender, which may be different to sex recorded at birth and may be different to what is indicated on legal documents.

If other, please specify*

What pronouns do you use?*

Age at time of application*

Please enter a number from 20 to 80.

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Age at date of application*

Day

Month

Year

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Title*

Email addresses

Email address*

Secondary email address

LinkedIn profile address

Residential address

Residential Location Area*

Postal address*

Street Address Suburb State / Province / Region ZIP / Postal Code

Postal address

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Same as residential address

Use residential address as postal address

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Street Address Suburb State Postcode

Phone

Mobile*

Other Phone

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Work Phone

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Employment

We understand you may be self employed or have multiple employers. If self employed please complete the questions for your business. If you have multiple employers, please complete the questions for your primary employer.

Are you self-employed?*

Yes

Do you have multiple employers?

Yes

Employer's Website

Employer name*

Position held*

Start date

Day

Month

Year

Size*

Employment sector (additional information)*

Employment sector*

Occupation*

Other occupation

Industry*

Other industry

Role category

Other role category

Briefly describe your role and responsibilities, outlining your annual budget, your team size and the number of direct reports*

Please outline your career prior to this role*

Education

Please list up to three, starting with most significant.

Organisation

City, state or region

Date attended

Day

Month

Year

Field of study

Level attained

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Organisation

City, state or region

Date attended

Day

Month

Year

Field of study

Level attained

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Organisation

City, state or region

Date attended

Day

Month

Year

Field of study

Level attained

Will you be enrolled in studies for a formal qualification next year?*

Yes

Please provide an estimate of time you are required to commit to this study per week, in hours*

Please describe the details of the qualification, or other training, and how you will manage the commitment, if you are successful in your application for the Tasmanian Leaders Program?*

Achievements

Up to 5 achievements

Honours/Awards/Fellowships

Year awarded

Issued by

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Honours/Awards/Fellowships

Year awarded

Issued by

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Honours/Awards/Fellowships

Year awarded

Issued by

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Honours/Awards/Fellowships

Year awarded

Issued by

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Honours/Awards/Fellowships

Year awarded

Issued by

About you

Have you lived outside of Tasmania?*

Yes

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How many years lived outside Tasmania?

Please enter a number greater than or equal to 0.

What states/countries have you lived?

Years Lived in Tasmania*

First language*

Other languages

Hold Ctrl / Cmd button to select multiple options

Are you Aboriginal and/or Torres Strait Islander?*

Yes, Aboriginal only

Yes, Torres Strait Islander only

Yes Aboriginal and Torres Strait Islander

Prefer not to answer

We are committed to meeting the needs of people with learning challenges or disability. Do you require additional support or have specific access requirements?

Yes

Would you like to discuss with a member of our team or provide us with specific details?

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Main personal interests/hobbies

A little more information

Have you read our information pack?*

Yes

Have you attended an information session?*

Yes

Year?*

Have you spoken to a Tasmanian Leaders Program graduate?*

Yes

Who?*

Have you previously applied for, or participated in a Tasmanian Leaders Program or short course?*

Yes

Detail of previous program*

Have you previously participated in any other leadership programs?*

Yes

Detail of previous leadership programs?*

How did you hear about this program?*

Employment information

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How many days per month does your work require you to travel outside of Tasmania?

Please enter a number greater than or equal to 0.

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Is this likely to change?

Yes

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Employer's postal address

Street Address Suburb State Postcode

Previous employers

Please provide your employment history for the last 10-15 years, starting with the most recent for a maximum of five.

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Employer name

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Position held

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Start date

Day

Month

Year

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End date

Day

Month

Year

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Reason for leaving

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Employer name

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Position held

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Start date

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Month

Year

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Year

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Employer name

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Position held

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Employer name

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Employer name

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Employer name

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Employer name

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Position held

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Reason for leaving

Community

Community interest 1*

Community interest 2

Community interest 3

Describe reasons for your interests*

Current or previous volunteer experience

The three most significant volunteering placements

Organisation name

Position held

Start date

Day

Month

Year

End date

Day

Month

Year

Hours committed per month

Please enter a number greater than or equal to 0.

Add another row

Organisation name

Position held

Start date

Day

Month

Year

End date

Day

Month

Year

Hours committed per month

Please enter a number greater than or equal to 0.

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Organisation name

Position held

Start date

Day

Month

Year

End date

Day

Month

Year

Hours committed per month

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More information

What do you consider to be your most important achievement in one of these organisations and why?

Are you as active in your community roles as you would like to be?*

Yes

Why/Why not?*

Do you see yourself becoming more involved in community activities in future years, and if so what has changed that now enables you to participate more and where/how would you like to be involved?*

Issues and Leadership

What do you believe are the emerging issues and/or opportunities of strategic importance for Tasmania that will demand exceptional leadership in the coming decade?

Issue 1*

Issue 2*

Choose one of the emerging issues and/or opportunities that you identified and describe your approach to creating a real and workable solution for it.*

When you think of current leaders and leadership, overseas and locally, what compelling leaders or leadership examples come to mind and why?*

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Title

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Title

You & TLP

Using a few phrases, describe yourself*

What do you consider to be your highest career achievement to date?*

Why are you interested in undertaking the Tasmanian Leaders Program and how do you think your participation will benefit you, your employer/business and Tasmania?*

What particular strengths and experiences do you think you would bring to the Tasmanian Leaders Program?*

Have you identified your core values, and if so can you please tell us what they are?*

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The Tasmanian Leaders Program will challenge your values, beliefs, thoughts and ideas. Are you open to being challenged?*

Sometimes our core strengths in one situation can be the achilles heel to another. Is there any specific behaviour you feel you should change to become a better leader? If so what is it?*

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What do you personally hope to gain from your participation in the Tasmanian Leaders Program?*

After completing the program, in what ways do you see yourself giving back to the community?*

Referee 1

Referees

Please provide details for two referees knowledgeable about your leadership performance and potential. At least one should be from your industry or organisation, and we ask that you avoid direct family members. Referees must be willing to answer a number of questions via an online form. This will be sent to them shortly after submission of your application. We encourage you to speak to them prior so they are prepared.

Name*

First Last

Relationship to you*

Time known

Job title

Organisation name

Email address*

Mobile

Referee 2

Name*

First Last

Relationship to you*

Time known

Job title

Organisation name

Email address*

Mobile

Approval

Employer approval

Please confirm that you have the full support of your organisation to apply for the Tasmanian Leaders Program. By selecting yes, you are confirming that your organisation understands the commitment required as outlined in the Information Pack, and are comfortable with the financial contribution and ongoing support you will require throughout the year.*

Yes

If you do not have the commitment of your employer/sponsor, please outline your reasons here or provide details to what level they can support you.*

Participant charter

In submitting an application to undertake the Tasmanian Leaders Program, you are making the following undertakings.

If chosen to be a participant in the Tasmanian Leaders Program (TLP), I will:

Code of Conduct
I will uphold the behavioural standards expected by the program and Tasmanian Leaders, serving as an ambassador for both. This includes treating my program peers, speakers and other guests with respect and professionalism always.

Attendance
I understand the importance of attendance and commit to attending all program days and associated events. In case of exceptional circumstances, I will communicate with program authorities.

Engagement
I will fully engage in all program activities, including surveys, pre- and post-work, and reflections, and complete them thoughtfully within the given timeframes. I will also work collaboratively with my fellow participants to plan and carry out any assigned group work, and for the Tasmanian Leaders Program commit to delivering a project as part of a Learning Set.

Ongoing Leadership
I will actively participate in leadership initiatives beyond program participation to support and promote a positive future for Tasmania, regardless of my location.

Graduate Search
I will register my skills and interests with Tasmanian Leaders, and I am open to collaborating with fellow graduates or responding to inquiries from the public through the Tasmanian Leaders Graduate Search. I will ensure my contact details are up to date to enable this.

Personal commitment

conf1

I confirm that the information provided in this application is true and correct

conf2

I confirm that I have viewed the information pack

conf3

I confirm that I understand the time commitment required to participate in the Tasmanian Leaders program and have discussed this commitment with my employer and family and I have their support

conf4

I will commit to full participation in the program, including the preparation of written reports to be provided to my sponsor

conf5

If required, I am prepared for information from this application to be shared with sponsors and specific session providers

conf6

I confirm that if accepted onto the program, I will pay the personal financial contribution of $1430.00

conf7

I confirm that I have reviewed and commit to the Participant Charter contained above

conf8

I confirm that I understand I am committing myself to increased involvement in the Tasmanian community upon graduating from the Tasmanian Leaders Program via a range of projects, activities and initiatives offered to graduates by Tasmanian Leaders

Scholarship

Scholarships are available to help individuals and organisations cover all, or a portion of the program fee to build capacity in a particular community or industry, based on the priorities of our scholarship partners. Please visit our website or contact our office to see if you might be eligible to apply for one.

Are you applying for a scholarship?*

Yes

The Select Foundation Tasmanian Leaders Program Scholarship (fully funded)

Q1. I would like to apply for the Tasmanian Aboriginal Scholarship (supported by TasNetworks to cover the full employer fee) and I confirm I am a Tasmanian Aboriginal person.

TasNetworks own, operate and maintain the electricity transmission and distribution network in Tasmania. For the 2025 program they are offering, in partnership with the Tasmanian Leaders Foundation, one scholarship for a Tasmanian Aboriginal person to cover the full employer fee.

Yes

Q2. Complete a candidate statement of up to 300 words outlining

a. The extent to which participating in the 2025 Tasmanian Leaders Program would positively impact your life;

b. The extent to which the scholarship will assist you in your representation of, and commitment to your community, culture and the general aspirations of Tasmania’s Aboriginal People; and

c. Any need or disadvantage the scholarship and program participation will assist them to overcome.

Q1. I would like to apply for the Select Foundation Tasmanian Leaders Program Scholarship (fully funded) and I confirm I identify as living with a disability.

The Select Foundation aims to assist in the funding of health and medical research and supports Tasmanian charities working to address disadvantage in our communities. In 2025 they will support and enable one fully funded scholarship for a Tasmanian living with disability, to participate in the 2025 Tasmanian Leaders Program. To be eligible you must confirm you live with disability.

Yes

Tasmanian Aboriginal Scholarship (supported by TasNetworks to cover the full employer fee)

Q2. Complete a candidate statement of up to 400 words acknowledging:

a. How you meet the eligibility criteria.

b. The extent to which participating in the 2025 Tasmanian Leaders Program would positively impact your life and/or help you to achieve your goals.

c. Your willingness to attending one Tasmanian Leaders supporter meeting or event in 2025 (at the cost of Tasmanian Leaders and to be mutually determined).

Tasmanian Leaders Non-Profit Scholarship (supported by the Board of Tasmanian Leaders to cover $2800)

Q1. I would like to apply for the Tasmanian Leaders Non-Profit Scholarship (supported by the Board of Tasmanian Leaders to cover $3,765) and I confirm I am employed by a small community-based not-for-profit or social enterprise with clear social outcomes in Tasmania.

The Board of Tasmanian Leaders is offering one scholarship of up to $3,765 to cover half of the employer fee for one successful applicant from a small community-based not-for-profit or social enterprise. The organisation must have clear social outcomes in Tasmania and the scholarship recipient must have demonstrated capacity, success and passion to lead their organisation. To be eligible you must be employed by a small community-based not-for-profit or social enterprise with clear social outcomes in Tasmania.

Yes

Q2. Complete a candidate statement of up to 300 words outlining:

a. Your demonstrable commitment to the Tasmanian community.

b. Your demonstrable capacity, success and passion in the not-for-profit sector.

c. Why you or your organisation needs financial support to pay for your professional/personal development.

Tasmanian Leaders Small Business Scholarship (supported by the Board of Tasmanian Leaders to cover $2800)

Q1. I would like to apply for the Tasmanian Leaders Small Business Scholarship (supported by the Board of Tasmanian Leaders to cover $7,530) and I confirm I manage a small enterprise or business, with considerable initiative and risk.

The Board of Tasmanian Leaders is offering one scholarship of up to $7,530 to cover the employer fee for one successful applicant from a small business in Tasmania with demonstrated capacity, success and passion to undertake future entrepreneurial projects. To be eligible you must manage a small enterprise or business, with considerable initiative and risk.

Yes

Q2. Complete a candidate statement of up to 300 words outlining:

a. Your demonstrable commitment as an entrepreneur, including key outcomes and successes over the past 5-10 years.

b. Your demonstrable capacity to drive the development and growth of a profitable entrepreneurial business.

c. Why you or your organisation needs financial support to pay for your professional/personal development.

HIA Building Women Scholarship (supported by the HIA to cover $6000 of the employer fee)

Q1. I would like to apply for the Changemaker Scholarship.

A Changemaker is someone who takes creative action to solve problems, big or small, from sparking a global movement to calling out a bully in a workplace. As either of these scenarios requires courage and a willingness to fail, we recognise the value the Tasmanian Leaders Program could provide such an individual and will cover as much of the employer fee as possible.

Yes

Q2. To be eligible you must: Have a vision and supporting action plan to progress a project that will create positive change or benefit the Tasmanian community. Complete a 300-word candidate statement addressing:

a. How participating in the Tasmanian Leaders Program will enable the applicant to develop necessary skills and build networks that will positively impact on the likelihood of their future successes. b. The details of the value of, and need for, financial support to participate in the program.

Application form feedback

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