Mid West Emerging Sports Leadership Program

The Mid West Emerging Sports Leadership Program is designed to deliver a fun, educational three session interactive workshop project that builds knowledge, learning and awareness in young aspiring leaders. This is targeted at 14-16 year old's in the Mid West region of WA. The program will provide these young leaders with a foundational platform to equip them with the skills and knowledge for their journey in developing effective leadership and life skills now and in the future.

  • Your full name?
  • Your current address?
  • This program targets 14,15 &16 year old's so please specify your age.
  • Please enter your date of birth.
    MM slash DD slash YYYY
  • Please provide a mobile number (in case of emergencies).
  • Please provide the best email address for contact with the applicant.
  • Please provide your parent / caregivers email address.

  • Program Delivery

    The program will be delivered over three separate workshops and attendance at all sessions is mandatory. There are two in person workshops in Geraldton and one online workshop. (In person) - Geraldton Saturday May 13 from 8:30 am to 12:00 pm (Online) Monday May 29 - 6:00 to 7:00 pm. (In person) - Geraldton Saturday June 17 from 8:30 am to 12:00 pm
  • The program will be delivered over three separate sessions and attendance at all sessions is mandatory. (In person) - Geraldton Sat May 13 from 8:30 am to 12:00 pm.
  • (Online) - Mon May 29 - 6:00 pm to 7:00 pm.
  • (In person) - Geraldton Saturday June 17. 8:30 am to 12:00 pm.
  • Please list the sports you play or are involved in?
  • Do you currently or have you ever volunteered at your local club / association and if so in what way? Please describe the role you performed and how that went?
  • Name of the parent / legal guardian who agrees with the attendance requirements and accepts all of the terms and conditions set out in this form.
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