Expression of Interest - Advisory Groups and Shire Committees

To submit your interest in joining an Advisory Group or Shire Committee, please complete the form below.

Please note: Expressions of Interest for the Audit, Risk and Improvement Committee are not accepted via this form. To express your interest in joining this committee, please see the nomination details.

Full name*

Address*

Email*

Phone number*

Please select an option that applies to you:*

Briefly state your interest in and/or experience relevant to the Advisory Group or Shire Committee you wish to join.*

Please describe how you believe you can contribute to this group or committee.*

Advisory group participants are welcome to request any specialist support to participate, (Eg: transport assistance, interpreter). If appointed, is there anything you need to make it easier to participate?*

No, I do not require any specialist support
Yes, I require specialist support

If you answered "Yes" to the question above, please detail any specialist support you would require to participate here.