2024 Multicultural Advisory Group Application Form

1.

How are you connected to Kwinana?

* required

Live in Kwinana

Study in Kwinana

Work in Kwinana

2.

What age group are you?

* required

15 - 24 years

25 - 35 years

36 - 50 years

Over 50 years

3.

What is your cultural background?

Maximum 70 characters

0/70

4.

First Name

* required

Maximum 30 characters

0/30

5.

Surname

* required

Maximum 40 characters

0/40

6.

What suburb do you live in?

* required

Maximum 40 characters

0/40

7.

Email

* required

8.

Phone

* required

Maximum 20 characters

0/20

9.

Why would you like to join the Multicultural Advisory Group?

* required

10.

What strength/s would you bring to the group?

* required

12.

What time/s would suit you?

* required

Mornings between 9am - 12pm

Afternoons between 12pm - 6pm

Evenings between 6pm - 8pm

13.

Do you give the City of Kwinana permission to share images and video related to the Multicultural Advisory Group for promotional purposes?

Select option