CoY TO LEAP Mentor EOI Form

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Complete this Expression of Interest Form to Register as a mentor in the TO LEAP programs

Email *

Your full Name *

Your email address *

Your mobile number *

Your postcode *

Tell us a bit about work and educational background *

What is your experience in. starting a business or community project? *

What skills, knowledge or industry area would you like to share with the participants and other mentors in the program *

I understand that attending an initial Information and induction workshop is a mandatory as part of joining the program.
*

Yes

Are you interested in attending 2 full days (9.30 - 4.30pm) of mental health first aid training? *

Yes

I already have a mental health first aid certificate

Other:

Which dates can you join an information and Induction workshop as well as 2 other training workshops
*

Online

In Person

I can't attend any

Thur 23rd July 5.30 - 8.30pm

Tue 28th July 5.30 - 8.30 pm

Sat 1st August 9.30 - 12.30pm

Sat 8th August 9.30 - 12.30pm

Sat 15th August 9.30 - 4.30pm

Sun 16th August 9.30 - 4.30pm

Sat 22nd August 9.30 - 4.30pm

Sun 23rd August 9.30 - 4.30 pm

What days and times can you attend IN PERSON workshops
*

Morning 9.30- 12.30 pm

Noon 1.30 - 4.30pm

Evening 5.30 - 8.30pm

I can't attend any on this day

Monday

Wednesday

Saturday

Where can you meet for workshops?
*

In Richmond

In the city

Within the Inner city area

Online

Other:

Required

Are you a currently living or have you ever lived in public housing?
*

Yes

Have you ever applied or received grant funding for a business or community project?
*

I don’t know what grant funding is

I have not and do not know how to apply for a grant

I have applied for grant funding

I have received grant funding

I have successfully delivered a community project or business idea that was grant funded.

Other:

About me. I am a person who is:

17 years old or under

Between 18 - 35 years old

Between 36 - 50 years old

Between 51 - 65 years old

Over 66 years old

Migrant, Refugee or CALD background

Indigenous or Torres Strait heritage

LGBTIQ

A woman or identify as a woman

I am underemployed

I am unemployed

I am a part-time or casual worker

Living with a disability

Living with a mental illness

Have experienced domestic violence

With caring responsibilities

Other:

I understand that TO LEAP Lead is an 10 week program and i will need to attend 80% of the IN PERSON workshops
*

Yes

I AM ABLE TO mentor participants for 3 months from Mid August 2026
*

Yes

Other:

I AM ABLE TO attend:
- 2 training workshops between July and August

- Meet participants at a workshop in Early September

Yes

Other:

How did you hear about this program
*

Send me a copy of my responses.

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