Application Form
2021 Program

Mission: Grow the leadership capacity and voice of people and communities

Confidential Application

The Alpine Valleys Community Leadership Program has been providing leadership development opportunities for North East and Border communities since 1998, and there are currently over 400 graduates of the Annual Program.  Thank you for expressing an interest in our 2021 Program.

Application Process

  • Please complete the online application form below. Otherwise, you are able to download a PDF version here – Annual Program 2021 Application Form. When completed, please email to
  • Applications close 5pm, Sunday 20 September, 2020
  • Applications will be reviewed by a panel and short-listed applicants will be required to attend an interview
  • Interviews will take place between September and October
  • All applicants will be notified of the outcome by late October
  • Successful applicants will be required to attend the compulsory Opening Retreat for the 2021 Program, scheduled for Friday 12 and Saturday 13 February 2021.

Instructions and Advice for Applicants

1. The selection panel uses the criteria detailed in this application. Please read and answer these questions carefully.

2. Complete each section in full.

3. Type or print all answers clearly.

4. Limit answers to available space.

5. One letter of recommendation will be accepted. No other attachments will be considered.

6. Where applicable, applications must be signed by both the Applicant and their Sponsor.

7. Applicants must have full support of the organisation they represent. Individuals may nominate themselves.

8. All nominations are subject to confidential evaluation.

9. Attendance at the Opening, Mid-Year, Closing Retreats and Graduation is mandatory. Participants must meet the minimum attendance requirement of 80% to graduate from the Program.

10. For each Program intake, a diverse mix of multicultural, indigenous, ethnic and religious, gender, location, private/public, and profit/non-profit sector participants are sought. The Program is committed to selecting candidates that represent communities from across the entire region.

11. Given the time commitments required to complete AVCLP, and to be fair to the individual, their employer and their families, it is unlikely that the panel will select an applicant who is also enrolled in other tertiary studies.

12. Offers in the program will be made by late October. Program fees are to be paid within 30 days of invoicing, prior to commencement of the program, unless other arrangements are made at interview.

NOTE: AVCLP is a highly regarded program and places are highly sought after. Some suitable candidates may not be chosen for this year’s Alpine Valleys Community Leadership Program because of the size restrictions of each year’s group and the need for diversity in group composition. However, individuals not selected are strongly encouraged to reapply in subsequent years.

For questions regarding the application process, please contact the Program Coordinator, Karlie Langdon, on 0437 827 548, or via email

Please complete online form below or email your completed application form PDF to

Step 1 of 3

  • Personal Information

  • Date Format: DD slash MM slash YYYY
  • Employment Information

  • Employment Experience

    List all employers within last ten years, starting with your most recent employment.
  • EmployerJob Title/RoleYears of Employment 
  • Education

    Please list all secondary and tertiary education experience, beginning with most recent qualifications.
  • InstitutionLocationYears AttendedQualification(s)Major Studies 
  • Provide details of any relevant professional development or leadership courses including units you have recently completed via employment, study and/or volunteer work.
  • Have you been awarded any special awards/ honours or prizes? (Education, community or work related)
    If yes, please provide details below.
  • Community Activities

    Please list in order of importance to you, up to five community, civic, professional, religious, social, sports or other organisations of which you are, or have been a member:
  • OrganisationDates of MembershipPosition(s) HeldHours Involved p/week 
  • Community Involvement

  • References