What is your name? *

First Name

Last Name

What is your best contact phone number? (optional)

(###)

###

####

How old are you?

18 to 30 years

31 to 45 years

46 to 60 years

60 plus years

Do you currently run a business?

Yes

No

If yes, how many employees do you have?

Sole Trader

1-10 employees

11-50 employees

51+ employees

Are you currently in a leadership role?

Yes

No

If yes, how many people report to you?

None

1-2 reports

3-10 reports

10+ reports

Do you identify as Aboriginal and / or Torres Strait Islander? *

Yes

No

What opportunities are you most looking with this program?

Select as many as relevant:

Networking

Building confidence in your strengths as a leader

Culturally safe leadership training

Help with a business idea

Growing a business

Exploring career options

Coaching and mentoring

Which location would you like to attend the 2-day face-to-face part of the program? *

Kalgoorlie WA: Two-Day Intensive - 15-16 Sept 2025

Karratha WA: Two-Day Intensive - Dates 18-19 Sept 2025

Mackay Queensland: Two-Day Intensive - Dates 13-14 Oct 2025

Sarina Queensland: Two-Day Intensive - Dates 20-21 Oct

Other