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)Are you a registered Club Changer Club?(Required) Yes No Tell us what the representation of women and girls playing and leading at your club looks like. Include up to 3 examples:(Required)Total registrations, number of teams, wellbeing support in place, mentorship and role modeling programs, women leading as coaches, administrators, volunteers etcWhat 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)Have you heard of Gaining Ground before? If yes, where? Word of Mouth Social Media Events Other Clubs Friends/Family Teammates Other Workshops will be delivered between 23 June until 21 July 2025. Would you prefer this workshop is delivered (select all that apply):(Required) Weekend Mornings between 8:30am - 12pm Weekend Afternoon between 1pm - 4pm Weekday Evening between 4:30pm - 6:30pm Are there any dates (weekends or weekdays that will not suit during this time frame)?(Required)Which days of the week are you available for the workshop? (select all that apply)(Required) Monday Tuesday Wednesday Thursday Friday Saturday Sunday Are you willing to host another club and do you have capacity for up to 60 people, with club room and field space?(Required)Is there anything else you think is important for Football West and Gaining Ground WA to know?(Required)
