To join our register of potential board or committee members, please provide the information below.
I certify that the information contained on this form and in my curriculum vitae is true and correct.
I understand that the lodgement of this form does not guarantee my appointment to a board or committee.
I understand that the information contained on this form and in my curriculum vitae will be retained by the Department of Environment and Science for the purposes of board recruitment.
I certify that I am 18 years of age or older.