EOI – Committee Membership | Leeton elementORG

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General Information

Prospective committee members should review the Committee Terms of Reference prior to submitting their membership application and address committee objectives in their application.
All nominations will be considered in accordance with the relevant Committee Terms of Reference.
Committee membership applications will be considered at a Council meeting and nominees will be advised of the outcome following the meeting.

Terms of reference information can be accessed under the "Committess of Council" page on Council's website.

Privacy: Information collected with this form will be used in compliance with Council's Privacy policy.

Personal Details

Name (as listed on your WWCC)*

First Middle Last

Email*

Note: all communications will be via email

Phone*

Date of birth*

Do you have a medical condition that might affest your ability to perform tasks while volunteering?*

Yes

No

Please specifiy*

Do you require any adjustments to your volunteer work environment?*

Emergency Contact Name*

First Last

Emergency Contact Phone*

Working with Children

A Working With Childrens Check (WWCC) is required for Council Volunteer committee members, this may be either the free volunteer or paid version.

If you don't currently have a check, you can complete this form but it will not be processed until the check is received. An email will be sent to you with instructions on applying and supplying the WWCC number to Council.

WWCC

I currently have a WWCC number

I'll need to apply for a WWCC number

WWCC Number

WWCC Expiry Date

Committee Details

Please select the committee(s) you are applying for*

Light Up Leeton Committee

SunRice Festival Committee

Whitton Courthouse and Historical Museum Committee

Whitton Town Hall Committee

Whitton Town Improvement Committee

Yanco Community Hall and Market Committee

Please outline why you would like to be a member of this Committee:*

Please outline any experience and/or qualifications you will bring to this Committee:*

Are you interested in an Officer Bearer’s position on the Committee? If so, please outline the skills or experience you would bring to such a position.*

Do you have any previous experience on Council's committees?*

Yes

No

Name of committee*

Nominee Acknowledgement

Privacy and Personal Information for Council Committees*

The information Council is collecting from you is defined as personal information under the Privacy and Personal Information Protection Act 1998 (“the Act”). The information may only be made available through this or other relevant Acts and Regulations that may apply.

The intended recipients of the personal information are:

officers within Council
agents or data service providers engaged by Council.

Council is collecting this personal information from you in order to process this membership application. If you cannot provide or do not wish to provide the information sought, the Council will be unable to process
your application.

As a member of a Committee:

Your name may be printed in the Reports of Committees and published on Council’s Web Page
Your name and contact details may also be made available to other Committee members.

You may apply to access or amend information held by Council. Council will consider a request to suppress your personal information from a public register in accordance with the Act. Enquiries concerning this matter can be addressed to the Governance Unit of Council. Council is to be regarded as the agency that holds the information.

I, , acknowledge the Privacy and Personal Information for Council Committees notice above regarding the Privacy and Personal Information Protection Action 1998 Pre-Collection (Section 10).
I confirm that I have read the contents of the notice and agree that the personal information may be used for the purposes identified and provided to the recipients identified in the notice.

Signature*

Submitted Date

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Workflow Timeline

Name

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