You must have JavaScript enabled to use this form. Full Name Your address (suburb)? Your email address Your contact number What is your best contact number? Do you identify as First Nations? Yes No What does reconciliation mean to you? What background, skills, expertise and knowledge will you bring to the Reconciliation Advisory Committee? Are you currently a member of any other committee or board? Yes No If yes, please provide the name of the committee or board. Have you ever been involved in the development of a Reconciliation Action Plan? Yes No If yes, please provide the name of the respective organisation. Would you be available to attend all Reconciliation Advisory Committee meetings held each quarter? Note: The first two meetings for 2026 will be held on 16 February and 18 May 2026. Yes No Unsure If no, please state your availability. By submitting this form, I hereby apply for membership on City of Darwin’s Reconciliation Advisory Committee for appointment for a 2-year term from 2026 to 2028. Yes No Leave this field blank
