Your Details First Name: Surname: Postal Address Post Code Phone Email Organisation (if applicable) Position title (if applicable) Nomination Details Please describe why you wish to nominate for membership of Council’s Arts and Cultural Development Advisory Committee? Please describe the particular skills and knowledge you would bring to the Arts and Cultural Development Advisory Committee? Please select your domain of expertise relevant to the ACDAC Committee Community Development and Education Arts and Culture Health and Well-being Social Justice and Advocacy Access and Inclusion Social and Cultural Planning and Project Management Community-centred Urban Design and Planning Please indicate if you identify as one or more of the following Young person (under 26 years of age) Culturally and/or Linguistically Diverse Aboriginal and/or Torres Strait Islander LGBTQI – Lesbian, Gay, Bisexual, Trans*, Queer, Intersex Differently abled and/or specific needs Do you have any access requirements for attending the meeting or for receiving electronic communications? Are you able to be an active member of the Committee through regular meeting attendance and electronic communications? Yes No Mark up privacy Please ensure you have read and understand City of Darwin's Privacy Statement before submitting. Privacy agreement I acknowledge that I have read and understand City of Darwin's Privacy Statement. I hereby apply for membership on City of Darwin’s Arts and Cultural Development Advisory Committee for appointment for a 2 year term from 2020 to 2022 I hereby apply for membership on City of Darwin’s Arts and Cultural Development Advisory Committee for appointment for a 2 year term from 2020 to 2022. CAPTCHA
Your Details First Name: Surname: Postal Address Post Code Phone Email Organisation (if applicable) Position title (if applicable) Nomination Details Please describe why you wish to nominate for membership of Council’s Arts and Cultural Development Advisory Committee? Please describe the particular skills and knowledge you would bring to the Arts and Cultural Development Advisory Committee? Please select your domain of expertise relevant to the ACDAC Committee Community Development and Education Arts and Culture Health and Well-being Social Justice and Advocacy Access and Inclusion Social and Cultural Planning and Project Management Community-centred Urban Design and Planning Please indicate if you identify as one or more of the following Young person (under 26 years of age) Culturally and/or Linguistically Diverse Aboriginal and/or Torres Strait Islander LGBTQI – Lesbian, Gay, Bisexual, Trans*, Queer, Intersex Differently abled and/or specific needs Do you have any access requirements for attending the meeting or for receiving electronic communications? Are you able to be an active member of the Committee through regular meeting attendance and electronic communications? Yes No Mark up privacy Please ensure you have read and understand City of Darwin's Privacy Statement before submitting. Privacy agreement I acknowledge that I have read and understand City of Darwin's Privacy Statement. I hereby apply for membership on City of Darwin’s Arts and Cultural Development Advisory Committee for appointment for a 2 year term from 2020 to 2022 I hereby apply for membership on City of Darwin’s Arts and Cultural Development Advisory Committee for appointment for a 2 year term from 2020 to 2022. CAPTCHA
