EOI Reconciliation Action Plan Working Group - Technical Advisor

First name

Last name

Phone number

Address

Postcode

Suburb

Postal address if different from above

Australian Business Number (ABN)*

Please advise of your hourly rate

Do you have a genuine interest and/or investment in helping to build positive relationships between Mid West Ports and Aboriginal and Torres Strait Islander communities? Please explain.

Are you committed to helping to workshop future ideas or initiatives relating to the Aboriginal and Torres Strait Islander community?

Are you available during work hours to attend and contribute to meetings with the Mid West Ports RAP Working Group?

YesNo

Are you willing to review, edit and provide feedback on draft RAPs?

YesNo

Do you have any Conflicts of Interest that may impact your ability to provide advice and guidance to Mid West Ports? If yes, please declare.

Please provide the names of two references and their contact numbers.

I declare all statements provided above are true and accurate

YesNo

Date submitted

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