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TRAIL Application Form
TRAIL Application Form
2021 TRAIL Application Form
Thank you for providing your personal information so that we will be able to undertake a recruitment process for the TRAIL Leadership Program. Your data is collected in compliance with our data collection and privacy policies which can be found on our website. Your data will be shared with the personnel responsible for the recruitment of the program and will be stored if you are successful in gaining a place on the program. If you experience difficulty in completing this form, please feel free to contact us as we will be able to offer you assistance to complete the application form in alternative methods.
1. Personal Details
Name
*
First
Middle
Last
Preferred Name
*
Date of Birth
*
Date Format: DD slash MM slash YYYY
Gender
*
With which gender do you identify?
Please select
Female
Male
Nonbinary
Transgender
Describe how you prefer to identify
Prefer not to disclose
Please specify
Do you identify as Aboriginal or Torres Strait Islander?
*
Please select
Yes, Aboriginal
Yes, Torres Strait Islander
Yes, both Aboriginal and Torres Strait Islander
No
Prefer not to disclose
In which country were you born?
*
Do you identify as any of the following?
*
Please select
Australian
New Zealander
Asian
Indian
Middle Eastern
European
North Amercian
South Amercian
African
Other, please specify
Please specify
*
What is your first language?
*
Do you speak any other languages?
*
Yes
No
Please specify
*
1.1. Contact Details
Mobile Number
*
Work Number
Email
*
Residential Address
*
Address Line 1
Address Line 2
City
State
Postcode
Afghanistan
Åland Islands
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Cook Islands
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Swaziland)
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Réunion
Romania
Russia
Rwanda
Saint Barthélemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen Islands
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
US Minor Outlying Islands
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Country
Postal Address if different to residential
Same as Residential Address
Address Line 1
Address Line 2
City
State
Postcode
Afghanistan
Åland Islands
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Cook Islands
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Swaziland)
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Réunion
Romania
Russia
Rwanda
Saint Barthélemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen Islands
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
US Minor Outlying Islands
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Country
1.2. Publicity
How did you hear about the TRAIL Leadership Program?
*
Program graduate
Internet search
Social media
Employer
Word of mouth
Industry news
Other (please specify)
Please specify
*
2. Industry and Community Involvement
Tell us about your employment, industry and community involvement and how it is supporting the agribusiness sector in rural, regional and remote Australia.
2.1. Current or most recent employment
Employment
*
Please select
Government (Local, State or Commonwealth)
Public Sector
Private Sector
Family Business
Self Employed
Volunteer
Homemaker
Social Sector
Other
Please specify
*
Sector
*
Please select
Food Fibre and Forestry
Arts and Culture
Community
Digital Technologies
Education and Training
Energy and Mining
Environment
Financial and Insurance Services
Health Care and Social Assistance
Hospitality and Tourism
International Development and Relations
Legal Services
Manufacturing/Processing
Not-For-Profit
Professional and Consultant Services
Public Administration
Social Enterprise
Sport Lifestyle and Recreation
Telecommunications and Media
Trade
Transport
Other
Please specify
*
Food Fibre and Forestry sub-sector
*
Please select
Beef
Bushfoods
Cotton
Dairy
Fisheries
Forestry
Goat
Grains
Horticulture
Pork
Poultry
Red Meat
Rice
Sheepmeat
Sugar
Wine
Wool
Other
Please specify
*
Position
*
Organisation
*
Responsibilities
*
Length of time in this position
*
Please select
Under 1 year
1-2 years
2-3 years
3-5 years
5-7 years
7+ years
3. Leadership responsibilities and major achievements
Leadership responsibilities
*
Briefly describe any leadership responsibilities in your work or community experience that you have undertaken. What valuable learning did you gain from your experience (s)?
Major achievements
*
Briefly describe any major achievements associated with your industry or community experience (paid or unpaid). This can include awards or scholarships.
Community positions
*
Please list any community positions you currently hold, length of term and responsibilities.
3.1. Leadership Programs
Have you completed any other leadership programs?
Please select
Yes
No
Leadership Program Name
Year Completed
Organisation
Other Leadership Programs
If you took part in any further Leadership Programs, please list them here.
3.2 Motivation and Background
Why do you want to undertake this leadership development program?
*
What impact are you having now as a leader?
*
What impact do you want to have on rural, regional and remote Australia as a result of your participation in this leadership development program?
*
4. Education
Note: There are no prior education requirements needed to undertake this program, this information is collected for statistical purposes only
Education Level
*
Please select
Postgraduate Degree
Graduate Diploma or Graduate Certificate
Bachelor Degree
Advanced Diploma and Diploma
Certificate Level
Secondary Education
Primary Education
Pre-Primary Education
Other
Educational Institution
Year completed
5. Referee Details
To support your application, the ARLF requires you to provide the contact details for two referees. Ideally this will be a professional referee and a personal referee. Please ensure you have asked their permission prior to submitting this application as the ARLF will contact them directly.
5.1. First Referee
First Referee Name
*
Relationship
*
Organisation
*
Email
*
Phone
*
5.2. Second Referee
Second Referee Name
*
Relationship
*
Organisation
*
Email
*
Phone
*
6. Health
General Health Assessment: Do you have any medical conditions/disabilities that could preclude you from any activities?
*
In the event that full disclosure is not made, the participant may be asked to leave the program. Applicants must disclose the nature and extent of any illness or disability to ensure that the ARLF can provide a safe learning environment for all and be able to meet its insurance requirements.
Yes
No
Please provide details
7. Agreement
Please read and indicate your agreement to the following terms.
7.1. I understand the cost of this Program is $9,500 plus GST
*
Yes
Please email the invoice to
*
First Name
Last Name
Email
*
Phone
*
7.2. I understand that I am required to make a participant contribution of $200 plus GST
*
Yes
7.3. I agree to commit to the residential components of this program and to make myself available for the duration of the program.
*
Yes
7.4. I understand that my participation is confirmed only when full registration payment is made.
*
Yes
7.5. I have read and agree to the Terms and Conditions.
*
View short course registration
TERMS AND CONDITIONS
. Also, you can view the ARLF Privacy Policy
here.
Yes
7.6. I declare that the information provided in this form is complete and correct.
*
Yes
Following receipt of your registration, the ARLF will issue an invoice for payment. Further details will be sent to you regarding the Program and the participant information required
About Us
History
Our Story
Our People
Our Staff
Our Board
Our Patrons
Our Associates
Work With Us
Support Us
Annual Reports and Resources
News
Our programs
COVID-19
Our Programs
Mentoring
Australian Rural Leadership Program
TRAIL: Emerging Leaders Program
Agribusiness
Milparanga Aboriginal and Torres Strait Islander Program
Other Programs
Alumni
Network & Portal
Members & Fellows
Honorary Fellows
Alumni Scholarship
ARLF Tables
Their Stories
ARLP Graduates
Sponsors & Partners
Become a Sponsor
Commission a Program
Sponsor & Partner List
Events
Event Calendar
Videos
Apply
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