Marcus Oldham Rural Leadership Program Application

Marcus Oldham Rural Leadership Program

Sunday 14th May to Friday 19th May 2023

Early bird applications must be submitted by COB on the 27th January 2023
This is a:*
- Early Bird Application $2800
- Full Fee Application $3300
Early Bird Applications are only accepted up until the 27th January 2023. Full fee applications are accepted after the early bird closing date until the closing date of the 3rd March 2023.
Personal Details
Name*
First Name Surname Preferred Name (for name tag)
Postal Address*
Street Address Address Line 2 or Property Name Suburb State / Territory Post Code
Current Age*
Gender*
Please describe how you prefer to identify
- Female
- Male
- Nonbinary
- Transgender
- Prefer not to disclose
Contact Information
Mobile*
Email*
Work Phone

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Education History
Please list your formal education to date.*
Please note: There are no prior education requirements needed to undertake this program. This information is collected for statistical purposes and to help plan the program.

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Leadership and Motivations
Please list here any current leadership roles you fulfill within your community, business or industry. Also, list any other leadership roles you may like to fulfill in the future.
Have you completed any other leadership programs?*
- Yes
- No
Other leadership programs*
Please list other leadership programs undertaken ensuring you include the year undertaken, program name and the organisation that ran the program.
Why do you want to undertake this leadership program?*

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Two Personal Referees
Name*
First Last
Relationship*
Phone Number (Business Hours)
Mobile Number
Name*
First Last
Relationship*
Phone Number (Business Hours)
Mobile Number
Agriculture - Which way next?
Please set out what you would like to achieve as a leader in agriculture (250 words or less).*

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Individual Requirements

If you have any dietary, learning, physical mobility or other individual requirements that we may be able to assist you with, please let us know.
Dietary Requirements
- None
- Gluten Free
- Nut Free
- Dairy Free
- Egg Free
- Vegetarian
- Vegan
- FODMAP
- Other
Other Dietary Requirements
Please list any other dietary requirements.
Other Requirements
If you have any learning, visual, physical mobility or other individual requirements we should be aware of, please list them here.

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If you are unsuccessful in your application, you will receive a full refund
Please nominate your payment method*
- Credit Card
- Direct Deposit/Invoice
- Cheque
Please send a cheque made out to Marcus Oldham College to:

Private Bag 116, Geelong Mail Centre, Victoria, 3211, Australia

Early Bird (by 27th January 2023) - $2800

Full Fee (after 27th January 2023) - $3300
Please make a payment to the following account and include your surname and MORLP May 2023 as the payment description.

BSB 013-523

Account: 2538 603 16

Account Name: Marcus Oldham College
Who would you like the invoice made out to?*
- Myself
- My sponsor
Marcus Oldham Rural Leadership Program May 2023 - Early Bird Fee
Price:
Marcus Oldham Rural Leadership Program May 2023 - Full Fee
Price:
Total
$ 0.00
Credit Card

MasterCard
Visa
Supported Credit Cards: MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name

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Apply now for the May 2023 Program