S.H.E LEADS 2022
LEADERSHIP PROGRAMME FOR YOUNG WOMEN 
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First name *
Surname *
I'm applying for *
Date of birth *
MM
/
DD
/
YYYY
Participant contact number
Participant contact email
Address *
School *
Year level *
Parent/ Guardian Name *
Parent/ Guardian Mobile number *
Parent/ Guardian email *
Who referred you to Leadership Programme/how did you hear about us? *
Would you like to receive information on other activities e.g for mothers? *
Mentoring
Mentoring is an essential part of the Leadership programme so that you get the most out of it. What days and times would best suit your time table for your monthly mentoring session to ensure your personal growth? Please note we cannot ensure the time you choose will be available, however we will take it into account and aim to organise the best fit for mentor and mentee!
Days (tick as many that apply) *
Required
Time (tick as many that apply) *
Required
Do you suffer from any medical conditions? (Please specify if yes) *
Media consent. I agree* to allow Fernhall to use my daughter’s images, photographs, videos for Fernhall's promotions and advertisements. * (must be filled out by parents/guardians) *
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