Working Group EOI Form Question Title * 1. Name: Question Title * 2. Email: Question Title * 3. Phone: Question Title * 4. Why would you like to join the Hub Working Group? Question Title * 5. Please provide details of any previous community work you have been involved in: Question Title * 6. Please provide examples of community issue or opportunities that are important to you. Question Title * 7. What do you like about the Community Hub? Question Title * 8. Could you please tell us a bit more about yourself (optional):Are you: Male Female Other Question Title * 9. Age range: 16-24 25-29 30-39 40-49 50-59 60-69 70+ Question Title * 10. Do you identify as: Aboriginal Torres Strait Islander Both Prefer not to state Question Title * 11. Are you from a non-english speaking background? Yes No Question Title * 12. Please provide contact details for a referee: Name Role Association with the applicant (how is the referee known to you) Email Address Phone Number Done
