Koo Wee Rup Longwarry
Flood Protection District
Terms of reference

Advisory CommitteeMembership nomination form

Thank you for your interest in participating in the Koo Wee Rup Longwarry

Flood Protection District Advisory Committee.

This form requires responses to a number of key selection criteria, along with the contact details of referees. You may also wish to include further supporting material.

Melbourne Water will review all applications and may undertake interviews with prospective candidates.

Protecting your privacy

Melbourne Water is dedicated to protecting the privacy of the personal information we collect from our customers. The Victorian Information Privacy Act 2000 requires that we collect and handle personal information in a responsible manner. Your application and personal details will be treated confidentially in accordance with the Melbourne Water’s privacy obligations.

Submitting your nomination

Please return your form and supporting materials by close of business on Friday 14 July 2017to:

Georgina Downey

Communications & Engagement

Melbourne Water

PO Box 4342, Melbourne VIC 3001

Or via email to:

You will receive notification that we have received your application.

Personal details

Name / Telephone number
Address
Email

Selection criteria

1. Please nominate with a tick which category you wish you represent on the Advisory Committee.

Resident from Koo Wee Rup
Resident from Longwarry
Local agricultural based interest group
Local community interest group
Local environmental interest group

If you nominated for a local interest group, please specify here the name of this group.

2. Outline your interest in and appreciation for local waterways and drainage management issues.

3. Outline your interest in and appreciation for local conservation and environmental issues.

4. Outline any existing connections, networks and links you have established within the Koo Wee Rup and Longwarry area, and how you may use these connections to communicate Committee information.

5. Outline your ability to provide constructive advice, citing previous experience in forums, advisory groups, community groups etc.

6. Outline what approach you will take to understanding broad community interests and communicating these in Advisory Committee meetings.

7. Describe the key issues for your community and its environment in relation to Melbourne Water’s work in Koo Wee Rup and Longwarry.

8. The Advisory Committee will meet every three months, during a working day. Please tick any preferred days or mark any days you are not available.

Monday / Tuesday
Wednesday / Thursday

Referees

Please provide contact details for two personal referees who would be able to discuss your capacity and ability to be a representative of the Koo Wee Rup Longwarry area.

Referee 1 / Referee 2
Name / Name
Relationship / Relationship
Contact no. / Contact no.