Nomination Form: Urban Greening Advisory Group To be a member of the City’s Urban Greening Advisory Group, you must be an elector (be on the electoral roll) of the City of South Perth.Nominations close at 4pm, Tuesday 28 April 2026. Question Title * 1. Before you proceed any further with your nomination, please confirm that you meet the following criteria: are an elector of the City of South Perth have read and accepted the Urban Greening Advisory Group Terms of Reference Question Title * 2. First name Question Title * 3. Surname Question Title * 4. Address Question Title * 5. Contact number Question Title * 6. Email address Question Title * 7. Age group 15-24 years 25-34 years 35-44 years 45-54 years 55-64 years 65+ years Question Title * 8. How would you describe your gender? Male Female In another way Prefer not to say Question Title * 9. Were you born in Australia? Yes No. Please specify country. Question Title * 10. Do you ever speak a language other than English at home? Yes always Yes sometimes Never Question Title * 11. Do you identify as Aboriginal or Torres Strait Islander? Yes No Prefer not to say Question Title * 12. Do you have a disability, or do you care for a family member with a disability? Yes No Question Title * 13. Which situation best describes you? Student Unemployed Retired Stay at home carer Employed/self-employed Other (please specify) Question Title * 14. If you are working or volunteering, which industry do you work in? Question Title * 15. Please tell us why you want to join the Urban Greening Advisory Group. Question Title * 16. What skills and experience will you bring to the Urban Greening Advisory Group? Thank you for your interest in joining the Urban Greening Advisory Group.The final decision on membership will be made by the CEO of the City of South Perth.Nominees under 18 must have their nomination reviewed and signed by a parent, guardian, or responsible adult. Question Title * 17. By signing this form, I declare that all information is true and correct.Please type your name for signature. Question Title * 18. Please enter today's date Question Title * 19. I confirm that I am the parent, legal guardian, or responsible adult of the nominee named above and that I approve their nomination and participation.Name (please type your name for signature) Question Title * 20. Relationship to nominee Question Title * 21. Email address Done