Torres Strait Youth
Leadership Program
4 to 11 March 2020
conversations, planning and implementing ideas and taking care of personal wellbeing
improve skills of communication and interpersonal skills, negotiation and influence, awareness of
values and behaviours,
increase their preparedness for personal and group involvement in continued and future leadership
roles in workplaces and communities within the Torres Strait
build connections with other leaders and become part of the broader network of the Australian
Rural Leadership Foundation which has a membership of over 1,400 leaders working, living and
leading across Australia.
Submission of your application
The completed registration form should be submitted either by email or in hard copy by COB 11 December 2019.
Email your registration to info@tsra.gov.au or you may mail the hard copy of your registration form to:
Torres Strait Youth Leadership Program
Torres Strait Regional Authority
PO Box 261, Thursday Island, Queensland 4875
This program is for young and emerging leaders who want to;
develop self-awareness in terms of working with others, making decisions, having important
APPLICATION FORM
(Application close 5pm, 11 December 2019)
Information about the program
The Torres Strait Youth Leadership Program (TSYLP) is for young and emerging people who have completed school and
want to further their education or start work. You must be of Torres Strait or Aboriginal descent and live in the Torres
Strait region. This program will challenge you in a range of different situations, requiring you to think about your
behaviour and how you relate to other people. You will meet influential leaders and consider your future leadership
options to represent people of the Torres Strait.
Questions
Because we specifically tailor our TSYLP program to our participant’s needs we need to gather background information
to support your application. We would appreciate it if you can complete the following with as much detail as you can.
Personal Details
Surname:
First Name:
Middle Name:
Preferred Name:
Title: (Ms, Mr etc)
Age:
Date of Birth:
Gender:
Male:
Home Address:
Home Phone No:
Email:
Current Employment
Employer:
Work Phone No:
Work Email:
Position Held:
Since (date):
Describe your responsibilities:
Health
General Health Assessment: Do you have any medical conditions/disabilities that could preclude you from any activities?
Please describe.
(Applicants must disclose the nature and extent of any illness or disability to ensure that the Foundation can provide a safe learning
environment for all and meet its insurance requirements. In the event this disclosure is not made, the participant may be unable to
participate in the program.)
Female:
Do you identify as Aboriginal or Torres Strait Islander? *
Yes: No:
Education and leadership development programs
Note: There are no prior education requirements applicants need to meet to undertake this program.
Highest Level Obtained:
Name/Location:
Years:
Qualification:
Other Relevant Courses:
Awards
What awards, scholarships or fellowships have you received?
Motivation
Why do you want to undertake this program? Will this program help you to make a contribution to your workplace
or community?
Participation
You must be able to commit the time and energy required to participate fully in the Torres Strait Youth Leadership
Scholarship Program.
As a prerequisite for acceptance, you will be required to agree to attend the entire session (the Foundation’s policy is
that leave of absence will only be granted in exceptional circumstances).
I will commit to full participation in the Program and understand I will have
limited telephone contact with my family during this program.
Yes
No
I have discussed this commitment with my employer and family and I have
their support.
Yes
No
If required, I am prepared for information from this application to be shared
with specific session providers.
Yes
No
If selected for this program, I agree to be part of photographs and other
media required by TSRA and the Australian Rural Leadership Foundation
Yes
No
Applicant’s Signature:
Date:
Lodging your registration form
Application close 5pm Wednesday 11 December 2019
Please email this completed registration form to:
info@tsra.gov.au OR send a hard copy of this completed registration form by post to:
Torres Strait Youth Leadership Program, Governance & Leadership, Torres Strait Regional Authority
PO Box 261, Thursday Island, Queensland 4875
* This Program is only open to Aboriginal and Torres Strait Islander People, and you may be asked to provide evidence of
your Aboriginal or Torres Strait Islander heritage.
Acceptable forms of evidence include:
A letter signed and executed by the Chairperson of an incorporated Aboriginal or Torres Strat Islander organisation,
confirming that you are recognised as an Aboriginal or Torres Strait Islander, or;
A confirmation of Aboriginal or Torres Strait Islander descent form executed by a delegated officer form an Aboriginal or
Torres Strait Islander organisation.
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