VICTORIAN RURAL WOMEN'S BUSINESS LEADERSHIP PROGRAM

APPLICATION FORM

Name*
First Last
Email*
Phone
Location*
Business name
Do you own a small business?*
- Yes
- No
If not, do you aspire to own your own business or other entrepreneurial activity?
- Yes
- No
- Unsure
Do you identify with any of the below (you may choose more than one):
- Aboriginal or Torres Strait Islander
- Culturally or linguistically diverse
- LBGTQI+
- Disabled
Let us know why you think this program would be good for you and your business?*

The Victorian Rural Women's Business Leadership Program is proudly supported by