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Expression of Interest-First Nations Advisory Group

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Thank you for your interest in membership of Council’s First Nation’s Advisory Group.

Using this form you can express interest in becoming a member, or nominate another person who you believe would be a worthy member. 

If you take this second option to nominate someone, Council staff will contact that person to see if they agree to be nominated. 

1.  

Are you nominating as a member yourself, or wanting to nominate another potential member?

* required

Please enter your details:

Maximum 255 characters

0/255

3.  

Your age:

* required
Select option

Maximum 255 characters

0/255

If you are nominating another person, please complete their details below. If you are just nominating yourself, leave this question blank.

Maximum 255 characters

0/255

Maximum 255 characters

0/255

10.  

Nominee age:

Select option
12.  

Do you (or your nominee) live, work or study in the Kempsey Shire:

* required
13.  

Which of the following describes you/your nominee?

* required