2024 HORIZON Program What is your name? * First Name Last Name What is your best contact email? * What is your best contact phone number? (optional) (###) ### #### What is your role/position? (optional) Which organisation do you represent? (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 If yes, what is/are your language group(s)? 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 What challenges / obstacles have you experienced in your current leadership journey Up to 50 words Are there any cultural preferences or considerations we should be aware of to ensure your comfort and cultural safety when participating with women from other language groups or regions? Up to 50 words Would you like to share anything else with us in your application? Up to 100 words Which location would you like to attend the 2-day face-to-face part of the program? * Kalgoorlie: 2-Day Intensive Other If you checked other, please state a regional location What regional location do you reside in? * Will you require crèche? If yes, please let us know how many children and their ages. Thank you for taking the time to express your interest.
