Queensland Indigenous Youth Leadership Program application form

Required fields are marked with an asterisk (*).

1. Eligibility

   Complete the questions below to check if you’re eligible to apply.

   1. Are you a Queensland resident? *

      You must be a Queensland resident to be eligible to apply.

      • Yes
      • No
   2. Are you 18–25 years old as at 16 September 2023? *

      You must be 18–25 years old to be eligible to apply.

      • Yes
      • No
   3. Have you previously attended the program? *

      Previous participants of the program are not eligible to apply.

      • Yes
      • No
   4. Do you identify as any of the following? *

      The program is open to Aboriginal and Torres Strait Islander participants only.

      • Aboriginal person
      • Torres Strait Islander person
      • Aboriginal and Torres Strait Islander person
      • None of the above
   5. Are you available to participate in the whole program in Brisbane from Saturday 16 September to Friday 22 September 2023? *

      This is a residential program, meaning it is compulsory for all participants to stay at the designated venue for the duration of the program and attend all group activities and dinners.

      • Yes
      • No
2. Personal and contact details

   These details will be kept confidential and be used to ensure duty of care to participants.

   1. Given name *
   2. Family name *
   3. Preferred name
   4. Gender *

      • Female
      • Male
      • Self-described
      • Prefer not to say
   5. Gender, self-described
   6. Date of birth *
   7. Do you speak a language other than English at home? *

      • Yes
      • No
   8. Language spoken at home
   9. Email *
   10. Phone *
   11. Address

       1. Street address *
       2. 1. Suburb or town *
          2. State * QLD
          3. Postcode
   12. Resume * Please upload a Microsoft Word or PDF version of your resume. Maximum file size is 10MB.
3. How did you hear about the program? *

   • Queensland Government website
   • Email
   • Local paper
   • Radio
   • Facebook
   • Instagrm
   • Past participant
   • Friend or family member
   • Other
4. Other
5. Leadership

   1. Why do you want to attend the program? * Maximum 2500 characters.
   2. What does leadership mean to you? * Maximum 2500 characters.
6. Community

   1. Where and how have you demonstrated leadership skills? * Your leadership experience could relate to work, family, school, studies, sport, community or previous leadership programs. Maximum 2500 characters.
   2. Describe the two most important issues affecting your community, and provide a solution on how this could be addressed?

      1. Community issue 1 * Maximum 2500 characters.
      2. Community issue 2 * Maximum 2500 characters.
7. Emergency contact details—next of kin

   Please nominate one person that the department can contact in case of an emergency, this person must know your medical history and have permission to talk on your behalf to medical staff.

   1. Name *
   2. 1. Relationship *
      2. Phone *
8. Alternative contact details

   Please nominate one person that the department can contact if, for whatever reason, we are unable to contact you. For example, if you have missed your flight.

   1. Name *
   2. 1. Relationship *
      2. Phone *
9. Referee contact details

   Please nominate two people that are not family members, which the department can contact to support and endorse your application.

   1. Referee 1

      1. Name *
      2. 1. Relationship *
         2. Phone *
   2. Referee 2

      1. Name *
      2. 1. Relationship *
         2. Phone *
10. Declaration

    1. I have read and understood the privacy notice and confirm that the information provided in this application is correct. *

       • Yes