Expression of Interest for Membership of Floodplain Management Committee

Contact Details

First Name *

Last Name *

Address *

Contact Number *

Email Address *

Eligibility for Membership

Please tick all relevant boxes *

Resident of the City of Canterbury BankstownCommunity or Environmental group representativeRatepayer in the City of Canterbury BankstownBusiness representative

Please provide information on your interest or knowledge in local flooding issues *

Please provide a statement of your commitment to represent the interests of the Canterbury Bankstown community in flooding and floodplain management issues *

Please provide a statement of ability to attend up to four committee meetings a year for a minimum two year period *

Other Information, Comments or Disclosures

Applicant Declaration

I agree that all the information provided on this application form is correct *

PRIVACY STATEMENT

In submitting this form, you consent to Council:

Collecting your personal information as contained in the form; and
Using the information for the purposes outlined in the form and for any other Council function.

Providing your information is voluntary. Should you choose not to provide the information, Council is unable to process your application/request.

You may access any of your personal information that Council holds upon request.

Signature *

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Date *