Online Form - Nomination Form - Equine Advisory Group

Full name *

Street address *

Suburb *

Email *

Phone number *

Please select the interest area you wish to represent *

Please provide brief details of any qualifications, skills, interest or experience you have that is relevant to the Equine Advisory Group. *

What has drawn you to nominate for the Equine Advisory Group? *

Please detail your involvement in any Council/Community Organisations/Groups or Committees, including the name of the organisation, your role and the dates of your involvement.

Are there any general comments you would like to make in support of your nomination?

Please provide the contact details of a referee who can support your nomination. *

I have read the Equine Advisory Group Terms of Reference *

Yes