Queensland Indigenous Youth Leadership Program application form

This application form will take about 30 minutes to complete. Once you start the form, it must be completed in full—you cannot save it and return to it later.

Before completing the form online, we recommend that you view the printable form (PDF, 610KB). This will help you prepare your responses and have all the information necessary to complete and submit your application correctly.

Further information about the Queensland Indigenous Youth Leadership Program can be found on the program fact sheet (PDF, 538KB). For further advice or to talk through your application ideas, please contact the Queensland Indigenous Youth Leadership Program Coordinator on 0459 899 637, during business hours (Monday to Friday, 9.00am to 5.00pm) or email QIYLP@des.qld.gov.au

Applications close midnight 25 April 2021.

Required fields are marked with an asterisk (*).

  1. Eligibility
    1. Are you a Queensland resident? * You must be a Queensland resident to be eligible to apply.
    2. Are you 18–25 years old by 26 June 2021? * You must be 18–25 years old to be eligible to apply.
    3. Have you previously attended the program? * Previous participants of the program are not eligible to apply.
    4. Do you identify as any of the following? * The program is open to Aboriginal and Torres Strait Islander participants only.
    5. Are you available to participate in the whole program in Brisbane from Saturday 26 June to Thursday 1 July 2021? * 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.
  2. Your details
    1. Gender *
    2. Do you speak a language other than English at home? *
    3. Residential address
    4. Postal address

      If not the same as address above.

    5. Maximum file size is 10MB.
  3. How did you hear about the program? *
  4. Leadership
    1. Maximum 2500 characters.
    2. Maximum 2500 characters.
  5. Community
    1. Your leadership experience could relate to work, family, school, studies, sport, community or previous leadership programs. Maximum 2500 characters.
    2. Describe the three most important issues affecting your community
      1. Maximum 2500 characters.
      2. Maximum 2500 characters.
      3. Maximum 2500 characters.
    3. Maximum 2500 characters.
    4. Maximum 2500 characters.
  6. 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.

  7. 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.

  8. 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
    2. Referee 2
  9. Declaration
    1. I have read and understood the privacy notice and confirm that the information provided in this application is correct. *

More information

Further information about the program can be found at www.qld.gov.au/qiylp.

For further advice or to talk through your application ideas, please contact the Queensland Indigenous Youth Leadership Program Coordinator on 0459 899 637, during business hours (Monday–Friday, 9am–5pm) or email QIYLP@des.qld.gov.au

Privacy statement

The Department of Environment and Science is collecting your personal information for the purpose of assessing your suitability and eligibility to participate in the Queensland Indigenous Youth Leadership Program in 2021. This information will be given to members of the judging panel which may include representatives of the Department of Environment and Science, other Queensland Government departments and Glencore. If selected, your personal information may be given to service providers for the purposes of securing accessible accommodation and facilities throughout the Queensland Indigenous Youth Leadership Program events. Your personal information will not otherwise be used or disclosed, unless it is lawfully authorised or required.