"*" indicates required fields Thank you for your interest in applying for the Crisis Leadership Program. To complete your application, you will need to provide your personal details, answer some short questions, and provide your CV and a completed employer support letter. 1. Required documents Understanding course and cost fees Course fees Course fees and associated costs for the in-person intensive module (or for CLP Extend, the five-day in-person course) are charged according to each participant’s employment (see Tier structure below). Course fees are subsidised for participants working with local organisations, with only some logistical costs to be paid for. Tier 1 Participants working for local NGOs or other local organisations. Tier 1 participants are not charged course fees, but are required to pay for transport to the intensive module location, and for some meals. Tier 2 Participants working for international NGOs or the UN. Tier 2 applications are required to pay course fees and travel costs (including accommodation and meals). CLP Seed Tier 2 costs: USD $400 CLP Grow Tier 2 costs: USD$550 CLP Extend Tier 2 costs: USD$550 Please note you will be required to provide: CV Attach a copy of your current CV. Written responses Provide written responses to the following statements: Why do you want to participate in the Crisis Leadership Program? Tell us about your leadership experience, either in your current job or a previous role. What would you describe as your key leadership strengths? Employer support form Have your Manager complete the Employee Course Support form. 2. Required documents Please complete the following documents and have them ready to upload as part of your application: Employer course support form 406.7K (pdf) 3. Additional Tips Keep all attachments under 5MB in size. All uploaded documents must be supplied as PDF format. Try to avoid applying on a weak or unreliable internet connection. Make sure everything is filled out and uploaded correctly. Step 1Personal informationName* First Last Preferred name Gender*MaleFemaleNon-binaryPrefer Not to AnswerPronouns* She/her Him/he They/them Email* Please list your primary email. We will use this email address for course communications.Phone*Date of birth* MM slash DD slash YYYY Personal Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Upload your CV* Drag files here or browse your computer Max. file size: 64 MB.Please upload your CV in either Word document or PDF. How did you hear about this course?*Email from my Line Manager/SupervisorEmail from a colleagueWord of mouthRecommended by a previous CLP participantOnline advertisingCHL website/social mediaOtherStep 2Course selectionPlease choose your preferred course from the available dates. What course are you applying for?*CLP SeedCLP GrowCLP ExtendAvailable dates for CLP Grow*12 October – 30 November 2023 | Intensive: 27- 30 November; Location: Bangkok16 November 2023 – 1 February 2024 | Intensive: 29 January - 1 February 2024; Location: IstanbulAvailable dates for CLP Seed*19 October - 7 December 2023 | Language: English | Intensive: 4-7 December; Location: Bangkok, ThailandCLP Seed is for people with between 0-2 year's experience (approximately) in the humanitarian and disaster response sectors. Available dates for CLP Extend*5 February - 9 February 2024 | Krakow, PolandExtend is for participants with more than eight (8) years’ experience leading teams and organisations in responding to disasters, emergencies, and humanitarian crises.Step 3Statistical informationWhat is your nationality?* In which country were you born?AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsPlease list your languages spoken* List of languages, separated by a commaWhat is the highest attainment of education you have received, prior to this course?*High SchoolAssociate DegreeBachelor's DegreeGraduate or Professional DegreeSome CollegeOtherPrefer Not to AnswerLast year of enrolment in prior education?* What is the name of the institution where you attained your highest level of education?* Step 4Eligibility criteriaDo you have 1-3 years’ work experience in an organisation or government body engaged in, humanitarian responses, emergency management, development programmes or crises response?* Yes No Unsure Do you have 3-5 years’ work experience in an organisation or government body engaged in, humanitarian responses, emergency management, development programmes or crises response?* Yes No Unsure Do you have more than eight (8) years’ experience leading teams and organisations in responding to disasters, emergencies, and humanitarian crises* Yes No Unsure If you have less than eight (8) years of experience in this field, then you should consider applying for the other CLP courses, Seed or Grow. Please select your level of English proficiency (verbal)* 0 – No Proficiency 1 – Basic Proficiency 2 – Limited Working Proficiency 3 – Professional Working Proficiency 4 – Full Professional Proficiency 5 – Native / Bilingual Proficiency It is important to note that all remaining CLP courses for 2023/24 are conducted in English. For CLP Grow and Extend, coaching is also offered in English only. Participants need to have sound command of the English language to participate fully in the course. Please email chl-clp@deakin.edu.au if you are unsure. I am prepared and able to commit to at least 3 hours of study a week for the duration of the course, and attend a three day intensive module.* Yes No Unsure Please refer to the dates and locations listed above. I am prepared and able to commit to attend the full five day course, and acknowledge that I will complete the required pre-reading and activities beforehand.* Yes No Step 5EmploymentWhat is your employment status?Employed Full-TimeEmployed Part-TimeSelf-employedNot employed but looking for workNot employed and not looking for workHomemakerRetiredStudentPrefer Not to AnswerWhat is the name of your current employer? Or, if you are unemployed, what is the name of your previous employer?* What is your job title? Or, if you are unemployed, what is the name of your previous job title?* How long have you been in your current position? What country do you work in?AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsPlease upload the completed employer support letter (available to download at the top of this page.* Drag files here or browse your computer Max. file size: 10 MB.The employer support letter is available to download at the top of this application form. Please download the form, have it signed by your employer (e.g. your Line Manager/Supervisor) and upload it with your application. Step 6Personal statementWhy do you want to participate in the Crisis Leadership Program?*Tell us about your leadership experience, either in your current job or a previous role. What would you describe as your key leadership strengths?*Is there any other information you would like to provide to support your application?Step 7Consent and agreementConsent* I acknowledge that I have read and accept the Information Privacy Statement for Students: https://www.deakin.edu.au/students/enrolment-fees-and-money/enrolments/student-information-privacyDeakin University collects your personal information from you directly by way of this application form. This information will primarily be used to assess your eligibility for admission into the CLP Seed course. If your application is successful, your information will be used to offer you a place on a course and to administer your acceptance or refusal of that place. You should also expect Deakin to use your personal information to: 1. Provide you with additional information related to your application for admission (e.g. about fees, scholarships, course requirements) 2. give you information on additional opportunities for studying at Deakin 3. help Deakin with marketing and fundraising initiatives 4. Conduct planning and quality assessment activities 5. Invite you to participate in surveys or research. As part of the selection process, Deakin will disclose your personal information to the extent necessary to verify your qualifications or experience. On admission into the course, the personal information collected in the application process will form part of your student record and will be managed in accordance with Deakin's Information Privacy Statement for Students located at: https://www.deakin.edu.au/students/enrolment-fees-and-money/enrolments/student-information-privacy. Please note that your academic results and performance will only be provided to you, and will not be disclosed to your employer, without your consent.Deakin University manages personal information it holds, including requests by individuals for access to their personal information, in accordance with the Privacy and Data Protection Act 2014 (Vic) and the Health Records Act 2001 (Vic).You have a right to gain access to your personal information held by the University. Information about Deakin’s privacy practices is available at http://www.deakin.edu.au/footer/privacy . You may obtain further information about privacy at Deakin by contacting the Privacy Officer at (03) 5227 8524 or at privacy@deakin.edu.auDeakin University manages personal information under the authority of the Deakin University Act 2009 (Vic). It also has a legitimate interest in the processing of personal information to determine eligibility for admission into its courses and, when admitted, to manage an individual's relationship with the University. The University’s Privacy Officer, Shirley Rooney, is the Data Protection Officer for the purposes of Regulation (EU) 2016/679 of the European Parliament and of the Council of 27 April 2016 on the protection of natural persons with regard to the processing of personal data and repealing Directive 95/46/EC (General Data Protection Regulation) OJ L 119/1, 4.5.2016 (GDPR). The Data Protection Officer may be contracted at (03) 5227 8524 or at privacy@deakin.edu.au As a resident of the European Union you have rights under section 3 of the GDPR. You may exercise your rights as a data subject in the following manner: Access: you may receive a copy of the personal information held by Deakin about you. Correction: you may request correction of the personal information Deakin holds about you. Objection to Processing: you may object to processing if you demonstrate that Deakin's processing of your personal information impacts on your fundamental rights and freedoms (as contemplated by the GDPR). Your objection to processing may be denied if Deakin is able to demonstrate compelling legitimate grounds to process personal information which override those rights and freedoms. Suspension of Processing: you may request that Deakin suspend the processing of your personal information if: a) you want Deakin to establish the data's accuracy before processing it; b) Deakin's use of the data is unlawful but you do not want it erased from Deakin's records; c) you need Deakin to hold the data to enable you to establish, exercise or defend legal claims; or d) you have objected to Deakin's use of your data but Deakin is in the process of verifying if it has overriding legitimate grounds to use it. Transfer to you or to a third party: if we hold your personal information in an electronic format (e,g. a database), we will provide it to you, or a third party in a structured commonly used, machine-readable format. Withdrawing consent: if Deakin processes your personal information based solely on your consent, you may withdraw that consent, however Deakin may not be able to continue to provide you with certain goods or services. If your withdrawal of consent relates to marketing material please follow the unsubscribe processes located at http://www.deakin.edu.au/footer/privacy .Final declarations* I have obtained Line Manager/Supervisor approval to participate in this course (if applicable). I commit to engage with the learning programme including attending, in full, all mandatory distance learning activities. Signed* Please list your initialsDate MM slash DD slash YYYY