SARRAH Leadership Course EOI

Applicant Name

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Your profession OR the allied health professional services provided by your practice (according to the definitions specified by Allied Health Professions Australia)

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Organisation name

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Contact phone number

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Contact email address

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Practice street address

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Suburb

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Select option

How many Allied Health Professionals in your practice?

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Solo 1

Small 2-5

Medium 6-15

Large 16+

Please explain in no more than 200 words the reasons you would like to be considered for this sponsorship, including your interest in leadership and progressing rural practice:

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10.

The SARRAH Leadership Program is designed to give you tools and strategies to apply the skills and knowledge gained to make a positive impact in your practice, community or field of work. What tricky leadership challenge(s) do you hope to explore by participating in the course?

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*Try to best articulate the challenge(s) that you would like to work on, even if they might not be clear. You may not be able to fully articulate your challenge(s), but you will work with your facilitator with guidance.

11.

How will you integrate this course into your schedule, ensure your mandatory participation in the sessions and completion of Leadership Action Plan?

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12.

Is there any other information you would like to provide to support your application.

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13.

Please read and accept the following conditions:

I have approval from my manager to undertake this program
I understand that places are limited in this program and should I be offered a course, I will endeavour to participate in all relevant coaching and education activities.
I understand if I do not attend the first meeting or are repeatedly absent, the PHN deserves the right to cancel this placement and offer to others on the waitlist.
I understand that the course is delivered over a period of months and hours (refer to EOI document for further details).
I understand I will be asked to participate in pre and post evaluation of the course.
I am prepared to devote the required time to complete the program and evaluation components.
I agree that de-identified information may be shared publicly to demonstrate program outcomes.
I agree that identified information relevant to the program such as leadership action plan will be shared with the PHN by SARRAH

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I agree