Springwood Youth Advisory Committee

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* 1. Nominee details

Name

Address

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 2. Date of birth

Date of birth

Date

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* 3. School (if relevant) and year level

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* 4. Tertiary institution or training (if relevant) and year level

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* 5. Occupation (if relevant)

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* 6. Community involvement to date (in your local community, school, and/or other organisation

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* 7. Local and/or State issues you are passionate about

Environment

Social Justice

Education

Health

Transport & Infrastructure

Other (please specify)

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* 8. Membership of any political party

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* 9. Reason for wanting to join the Springwood Youth Advisory Committee

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* 10. What qualities do you believe you would bring to the committee