2026 PERTH FELLOWSHIP
EXPRESSION OF INTEREST
Who are you e
xpressing interest for?
I am expressing interest for myself
I am expressing interest for my organisation and/or team
CONTACT DETAILS
First Name
Last Name
Email
Phone
Your role or capacity
Your organisation or movement
City / Suburb
Postcode
State
Please select...
NSW
VIC
ACT
NT
QLD
SA
TAS
WA
NZ
Other
YOUR IDENTITY
Demographic information:
The information we collect helps shape our content and strategies so we can best serve our community and reflect the diversity of our participants. If you would like to update your details, or have any questions or concerns about how your data is collected, please contact info@australianprogress.org.au.
Do you identify as
Aboriginal and/or Torres Strait Islander
First Nations person from outside Australia
Person with disability
Refugee or person seeking asylum
Person of colour
Unwaged activist - not currently paid for your organising or campaigning work
Who is your mob?
Which of the following best describe your gender? (Select all that apply)
Man
Woman
Non-binary
Another term or identity
Prefer not to say
Another term or identity: (please describe below)
By submitting my interest, I consent to being contacted for updates about the Perth Fellowship and to join the Australian Progress mailing list for updates about other events and training.
YOUR DETAILS
First Name
Last Name
Email
Phone
Your role or capacity
Your organisation or movement
City / Suburb
Postcode
State
Please select...
NSW
VIC
ACT
NT
QLD
SA
TAS
WA
NZ
Other
How many staff would you want to participate in the fellowship?
1 person
2 people
3 people
PERSON 1
First Name
Last Name
Email
Phone
Role or capacity
Organisation or movement
City / Suburb
Postcode
State
Please select...
NSW
VIC
ACT
NT
QLD
SA
TAS
WA
NZ
Other
PERSON 2
First Name
Last Name
Email
Phone
Role or capacity
Organisation or movement
City / Suburb
Postcode
State
Please select...
NSW
VIC
ACT
NT
QLD
SA
TAS
WA
NZ
Other
PERSON 3
First Name
Last Name
Email
Phone
Role or capacity
Organisation or movement
City / Suburb
Postcode
State
Please select...
NSW
VIC
ACT
NT
QLD
SA
TAS
WA
NZ
Other