Harvard Club of Australia

The Clive Gard Leadership Program Scholarship

Application Form


Applicants Details

Referee's Details
Please name a referee to verify your work experience

* Title   
(Prof, Dr, Mr, Ms)
* Surname   


* Initials    * Given Name   


Hons    * Organisation   


* Given Name    * Position   


* Surname    * Email   


* Organisation    * Telephone   


* Position       
* School   
 * Degree   

Selection Criteria
(1) Must be a financial member of the Harvard
Club of Australia or the Harvard Club of Victoria.
(2) Is permanently resident in Australia.
(3) Has post graduate qualifications.
(4) Has at least five years work experience.
(5) Is available to attend the program 2019

Please provide in the space below:
(1) Why you seek to attend the Leadership Program
(2) What personal and career development you expect
to obtain by attending.
(3) How do you see yourself contributing to the
ongoing activities of one of the Clubs

* Year   
* Email   
* W-Tel   
* Mobile   
* Address A   
Address B   
* Suburb/City   
* State   
* Postcode   

 Maximum characters 2000



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