SSLP Application Form

Stronger Smarter Jarjums Program - National - Ballina, NSW 

Phase 1: 24 - 27 November 2020

Phase 2: 18 & 19 February 2021

Venue: Ballina Surf Club, East Ballina NSW 

If you are interested in participating in this program, please complete the following form:

* mandatory field
PERSONAL DETAILS
Title
Given names*
Surname*
Gender


Address
City/Suburb
State
Postcode
Phone numbers
 
 
Email address*
Dietary requirements
Any special requirements
(including medical conditions we need to know)
Emergency contact details
 
 
Shirt size
Educational attainment











Are you Aboriginal, Torres Strait Islander or Australian South Sea Islander origin?
(check all that apply)





WORKPLACE DETAILS
Position title
(eg Principal)
Workplace
(eg Summerland Public School)
Address
City/Suburb
State
Postcode
Phone number
ABN number*
Name of Accounts Payable Officer*
Account Payable Office Email Address*
INDIGENOUS STUDENTS
Please provide the following information regarding student data in your workplace
Number of Indigenous student enrolments
Total student enrolments
Percentage of Indigenous student enrolments
YOUR INTEREST IN THIS STRONGER SMARTER PROGRAM
Briefly explain your reasons for applying to participate, including your career goals.
Please include any factors relevant to your application
How did you find out about this program?
DECLARATION
Please read and acknowledge that you understand that*:
Completing this application form does not guarantee you a place in the program. Following receipt of your application, you will be notified of the status of your application by email.

Engagement in the Stronger Smarter Programs is a commitment that requires attendance at both residential sessions and completion of all other program phases.

Once you accept a place in the program, cancellation within 14 days of the first residential program will be subject to a cancellation fee.