Believe Achieve Inspire Application Form 2016

Believe Achieve Inspire Application Form
Personal details
First Name*
Last Name*
Gender*
Age*
Mobile*
Email*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Residency Status*
How did you hear about the program?

Family or friendEmailFacebook/TwitterAt an event presentationFrom the Islamic Society at university
Education, Employment and Volunteering
Highest Qualification Completed*
Current or recent education/training (if not applicable, enter "Not applicable")*
Current employment (if not applicable, enter "Not applicable")*
Your community or voluntary involvement. Describe your role (if not applicable, enter "Not applicable")*
Program interest
Share with us a problem or project that you've encountered in your personal or academic or work life. How did you overcome it? (We would like to know how you generally solve problems)*
Share with us one of your community interests? Explain why it is a important to you (We might include topics that are relevant to your interest)*
What do you want to get out of this leadership program? *
Have you ever been late to a meeting or an appointment or late in submitting work?
What are your long career and community goals
Do you need any special assistance to help with your learning?
Short Quiz
You have a team assignment that needs to be completed by 5pm today. You've completed your part but its not fantastic. Your team member hasn't completed his task. Do you continue on with your work to ensure it is fantastic or do you leave it and help your team member? You can't do both.
A screw and its nut cost $1.10. The screw cost 1 dollar more than the nut. How much does the screw cost?
All tulips are flowers. Some flowers fade quickly. Therefore, some tulips fade quickly. Do you agree with the conclusion?
Sign off

Provide one personal or professional referees. (no family members)
Name of referee*
Organisation*
Phone*
Email*
Relationship to applicant*
Personal commitment
Tick to indicate your agreement.*

I understand and commit to the time required to participate in this program
I commit to making a financial contribution of at least $29/week for 1 year
I understand that I am commiting myself to more community involvement upon graduating.
Date*
All applications will now be reviewed by a selection panel and applicants will be advised of the outcome of their application before the start of the BAILP year (End of July 2016). Thank you for applying to Believe-Achieve-Inspire.
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Believe Achieve Inspire Application Form

Personal details

Education, Employment and Volunteering

Program interest

Short Quiz

Sign off

Personal commitment

All applications will now be reviewed by a selection panel and applicants will be advised of the outcome of their application before the start of the BAILP year (End of July 2016). Thank you for applying to Believe-Achieve-Inspire.