Gaining Ground Mentorship and Wellbeing Club Application Name(Required) First Last Email(Required) Phone(Required)Which football club or association do you represent?(Required)What is your role at your club?(Required)Total number of junior girls teams aged 12 - 14 years registered at your club in 2025?(Required)This field is hidden when viewing the formAre you a registered Club Changer Club?(Required) Yes No Are you a registered Club Changer Club?(Required) Yes No What does the representation of women and girls playing and leading at your club look currently look like? Include up to 3 examples:(Required)For example; wellbeing support in place, mentorship and role modeling programs, women leading as coaches/administrators/volunteers, etc.What are 1-2 goals you have this season to support the leadership and wellbeing of your women and girls players?(Required)What is your vision for the women's and girls’ participation and leadership of your club?(Required)Why are you investing in the wellbeing and leadership of women and girls at your club?(Required)What are 1-2 challenges your club is facing for this age group?(Required)Workshops will be delivered Saturdays between 21 June until 26 July 2025. Please select your availability (select all that apply):(Required) Saturday 21 June, 10am-11:30am Saturday 21 June, 1pm-2:30pm Saturday 28 June, 10am-11:30am Saturday 28 June, 1pm-2:30pm Saturday 26 July, 10am-11:30am Saturday 26 July, 1pm-2:30pm Are you willing to host another club and do you have capacity for up to 60 people (club room and field space)?(Required)Is there anything else you think is important for Football West and Gaining Ground to know?(Required)
