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Application for Monash Leadership and Management Events

Event Date:

Leadership in Action 2009

Please tick one box indicating the program you wish to attend. 

Please note that there is a three day residential component and a one day follow-up sesssion.

  16-18 February (3 day residential) and 26 March

  20-22 April (3 day residential) and 22 June

  27-29 July (3 residential) and 11 September

  20 - 22 October (3 residential) and 27 November
Title:
First name:
Surname:
Gender: Female
Male
Department:
Faculty/Division:
Campus/site:
Email address:
Phone number:
Dietary Requirements:

Payment and Cancellation Policy:

* Registration for Academic Heads Network Meetings is free of charge, however, payment details must be entered below as payment will be charged a where 48 hours notice (in working days) of inability to attend is not received. 

* Participation in the Academic Heads Conference and Leadership in Action is free of charge, however, payment details must be entered as a cancellation fee will be charged in the event of cancellation.  The following terms apply:
Less than 30 days notice cancellation - 50% of program costs will be charged 
Less than 14 days notice cancellation - 100% of program costs will be charged

 Payment details must be completed to confirm registration.
1. Cost centre and fund

Account Code
Cost Centre
Fund
2. Debtors Invoice: (for Departments not on SAP)

The information on this form is collected for the primary purpose of processing your application to attend a Leadership Forum. Other purposes may include communicating with you, program administration, and reporting and de-identified statistical analyses. You have a right to access personal information that Monash University holds about you, subject to any exceptions in relevant legislation. If you wish to seek access to personal information or inquire about the handling of your personal information, please contact the University.