Tackle Your Feelings 2022 Psychologist Facilitator Application Form "*" indicates required fields Get Involved Tackle Your Feelings 2022 Psychologist Facilitator Application Form Applications to be a Tackle Your Feelings Psychologist Facilitator for the 2022 season are now open. Please complete the application form below, including nominating the specific region/s local to your area of practice. Should you experience any issues with this process, then you should email email@example.com Before you start, please prepare the following: Film a two-minute video explaining why you’d like to take part in the Tackle Your Feelings program Maximum file size is 64MB Prepare a CV of your work experience Maximum file size is 2MB All fields are required and the form must be completed and submitted in one sitting Step 1: Personal InformationName* First Name Last Name Street Address* Suburb* State*SelectACTNorthern TerritoryNSWQueenslandSouth AustraliaTasmaniaWestern AustraliaVictoriaPostcode* Please select the region/s your practice is local to (regional - within 100km / metro - within 25km):*SelectACTNorthern TerritoryNSWQueenslandSouth AustraliaTasmaniaWestern AustraliaVictoriaSelect region* Bundaberg Rockhampton Select region* Port Pirie Select region* Bairnsdale Ballarat Cobram Edenhope Geelong Horsham Lakes Entrance Swan Hill Warragul Warrnambool Whycheproof Yarrawonga Select region* Bunbury Carnarvon Geraldton Karratha South Hedland We are not recruiting in your state in 2022. If you are not local to any of the regions listed, but you’d like to be considered for delivery in 2023, then you do not need to complete this form and you should email firstname.lastname@example.org.Personal Email* Personal Phone*Professional Email (will be given to workshop participants)* Professional Phone (will be given to workshop participants)* Step 2: Practice InformationAre you an AHPRA-registered psychologist?* Yes No Do you have an ABN?* Yes No Please note: You will be required to set one up upon application success. If you have an ABN, provide number here Are you connected in any way to a local football club? (Yes/No) If Yes, please provide club name and type of involvement*Do you have availability to deliver programs on weeknights (and weekends if needed)?* Yes No Do you have the capacity to receive referrals that may flow from participating clubs?* Yes No Step 3: Personal ApplicationProvide a short overview of your mental health experience working with junior, youth and adult clients ( 1 - 2 paragraphs)*Provide a short overview of your experience and understanding of community sport, in particular AFL (1 paragraph)*Provide examples of your experience in presenting to groups (1 paragraph)*Detail your proficiency in the use of technology, such as Microsoft PowerPoint, Excel, Zoom, and/or eLearning platforms (1 paragraph)*For uniform purposes (polo/jacket), what is your clothing size? (true fit)*Please selectWomens SmallWomens MediumWomens LargeWomens XLWomens XXLWomens XXLMens SmallMens MediumMens LargeMens XLMens XXLMens XXXL Step 4: File UploadPlease upload a short video (max 2 mins) explaining why you'd like to take part in the TYF program.*Accepted file types: mp4, mov, Max. file size: 128 MB.If you have trouble uploading your video, contact: email@example.comPlease upload your CV here (PDF format)Accepted file types: pdf, Max. file size: 2 MB.Please do not close your browser or refresh this page until the form has submitted.EmailThis field is for validation purposes and should be left unchanged.