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Form
Active Ageing & Inclusion Advisory Group EOI
Active Ageing & Inclusion Advisory Group EOI
Name
First name
Last name
Email
Address
Township
Phone Number
Connections to the local community
Please describe your connections to local community within the Golden Plains Shire.
Knowledge of Access and Inclusion Barriers in the Community
Please describe from your lived experience in the community an understanding of any current accessibility barriers that have or could impact access to the local community.
Attributes/Skills
Please list any other attributes or skills relevant being a member of the Active Ageing and Inclusion and Advisory Group.
Other
Please list any other information of relevance.
Privacy Statement
Personal information collected on this form will be used by Council's Active Ageing & Inclusion Department to build the Active Ageing & Inclusion Advisory Committee.
If you do not provide us with all required information, Council reserves the right to remove your submission from the EOI process. You have the right to access your personal information and make any necessary corrections. If you have any enquirie or wish to gain access to amend your information, please contact Golden Plains Shire's Privacy Offier on (03) 5220 7111 or
[email protected]
.