HEPO MEMBERSHIP INTEREST FORM

Become a HEPO Member Organization

Complete the form below to express your organisation’s interest. Submission creates no financial, legal, enrolment, sponsorship, or participation obligation – it simply allows the University of Gold Coast Leadership Academy to process your organisation for recognition and keep your nominated contact informed about HEPO benefits and opportunities.

Fields marked with an asterisk are required. Your information is used only to process HEPO membership and is handled in line with our Privacy Policy.

Section 1 - Organisation

Organisation Name *

Type of Organisation *

Postal Address

Physical Location

Website / URL

Official Email *

Main Telephone Number *

Section 2 - Contact person

Name of HEPO Contact Person *

First

Middle

Last

Position of Contact Person

Mobile Number (Contact Person) *

Email Address (Contact Person) *

Section 3 - Interest

Approximate Number of Staff

Staff Categories That May Benefit

Supervisors & team leaders
Middle managers
Senior executives & directors
All of the above

Programme Level of Interest

Level One — First-Line Management
Level Two — Operational Leadership & Management
Level Three — Senior Executive Leadership
All three levels

Preferred Name for Certificate

Section 4 - Authorisation

Name of Representative *

First

Middle

Last

Position of Representative *

Declaration *

We understand that becoming a HEPO member organisation does not create any financial, legal, enrolment, sponsorship, or participation obligation for our organisation.

WHAT HAPPENS NEXT

The University of Gold Coast Leadership Academy reviews your submission and contacts your nominated representative. Approved organisations may receive a Certificate of Recognition as a Member Organization of HEPO. Your organisation or eligible staff may then access HEPO benefits whenever you choose to participate.

Prefer to speak to someone first? Contact the HEPO Desk →

Become a HEPO Member Organization

Section 1 - Organisation

Section 2 - Contact person

Section 3 - Interest

Section 4 - Authorisation

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