<p>Application form: Shared Leadership Program 2017</p><p>Please return your completed application form by Friday 23 September 2016 to: Jessica Cannane, Project Coordinator, Public Libraries State Library Victoria Email: [email protected] Phone: (03) 8664 7323</p><p>Applicant information (to be completed by applicant) Name: Position: Library service: Branch or division: Address: Telephone: Email: 1. Outline your work history, focusing on career achievements, professional development and major milestones (100 words):</p><p>2. Why do you believe you should be selected for the 2017 Shared Leadership Program? Please outline the benefits for you (100 words):</p><p>3. What would be the benefits for your library service? (100 words):</p><p>4. What does ‘leadership’ mean to you? (100 words):</p><p>5. Where do you believe you need to develop your leadership skills and knowledge? (100 words):</p><p>6. What is your vision for public libraries and/or State Library Victoria in five years’ time? (100 words):</p><p>7. Are you prepared to commit extra time outside workshop modules and normal working hours to complete an action learning project?</p><p>Please note: Applicants are not required to submit an action learning project idea in order to apply for the program. If you would like to submit an idea, please do so using the Idea Nomination form.</p>