Coronavirus (COVID-19) updates from the Australian Government

Building Resilient Regional Leaders Initiative (Pilot) submission form

Please use the form to provide your details for the Building Resilient Regional Leaders Initiative (pilot).

Fields marked with required field icon are required to be filled in.

Your contact details
Organisation contact details (public)
(max 2 paragraphs/150 words)
Targeted demographic/industry group to meet objective of the program
Number of participants required for program viability, maximum number of participants for effective program (no names)
(max 2 paragraphs/150 words)
Circumstances the region is recovering from and/or future challenges participants want to be prepared for


The department is collecting personal information in accordance with the Privacy Act 1988, and as authorised under the Building Resilient Regional Leaders Initiative (Pilot) guidelines, for the purposes of providing place based leadership training programs in Regional Australia.

The department will use your personal information to inform potential program applicants (training providers) of your region's interest in the program and will store this information securely. The department may disclose information to training providers for their consideration in developing applications for the program. If you do not provide the information requested, training providers will not be made aware of your region's interest in the program via the noticeboard tool.

The department's on-line privacy policy contains information regarding complaint handling processes and how to access and/or seek correction of personal information held by the department. The Privacy Officer can be contacted on (02) 6274 6495.