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New Horizons Intake Form

Awesome! You clicked the "apply now" button. You've taken the first step towards the next direction you're career is going to take.
So we can get started on this journey together can you let me know a few details about yourself.

This program is designed for women who:

(tick all that resonate for you)
This program is designed for women who:

Brilliant! It looks like you are in the right place.

Each session consists of 3x face-to-face workshops.

These workshops will run 9:30am until 2:30pm at the Community Information Centre, Northtown, 280 Flinders St, Townsville CBD.
You will need to attend all three workshops plus commit to some after hours homework to successfully complete this program.
Are you able to attend the all three workshops during these times at this location?
Each session consists of 3x face-to-face workshops.
A
B
C

Which session will you be attending?

(each session is capped at 25 participants)

Great - we've got your session locked in.

What is your first name?

What should we call you (if it's something different to your first name)?

And so we don't get you confused with anyone else who goes by the same name, what is your last name?

Where should we email further details?

What is your phone number?

Just in case our email gets lost on its way to you.

We will be providing morning tea and lunch. Do you have any dietary requirements we need to know about?

We will be providing morning tea and lunch. Do you have any dietary requirements we need to know about?