Nomination Form for Gateway Reviewers

Please complete the following form and attach a curriculum vitae of no more than five (5) pages to support your application

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Title
First Name
Last Name
Position
Division
Organisation
Government
ABN
Daily Rate (inc. GST)
Postal Address
Street Address
City / State / Post Code
Country
Phone / Mobile / Facsimile
Email Address
Accreditation/Training / Please click to selectReview Team MemberReview Team LeaderNone Date:
Industry/Sector Experience Please check all relevant options
Accounting
Agriculture
Architecture/Design
Arts/Entertainment
Audit
Banking/Finance
Construction
Economics
Education/Training / Emergency Services/
Law Enforcement
Engineering
Government
Health/Medical
ICT
Insurance
Legal
Local Authority / Logistics
Manufacturing
Mining Resources
Science & Technology
Telecommunications
Town Planning
Transport/Rail
Utilities
Water
Skills and Strengths Please check all relevant options
Business Case Development
Business Change Management
Business Strategy Development
Communications/ Marketing
Community/Stakeholder Consultation
Contract Management
Corporate Planning / Customer Service
Human Resource Management
ICT
Industrial Relations
Logistics
Network/Systems
Operations
Policy
Procurement
Program/Project Management / Property Development/ Management
Quality Assurance
Quantity Surveying
Records Management
Research
Risk Management
Safety Management
Service Delivery
Tender Evaluation
If you possess prior Gateway Review experience, please provide further details below, including information such as: jurisdiction, project, year etc.

Information provided in this form can be shared with the Commonwealth and other State Agencies Gateway Units. Yes No

SIGNED: DATE:

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